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脉搏血氧测定法作为阻塞性睡眠呼吸暂停筛查工具的应用:台湾地区的一项案例研究。

Use of oximetry as a screening tool for obstructive sleep apnea: a case study in Taiwan.

作者信息

Huang Shou-Hung, Teng Nai-Chia, Wang Kung-Jeng, Chen Kun-Huang, Lee Hsin-Chien, Wang Pa-Chun

机构信息

Department of Psychiatry & Psychiatric Research Center, Taipei Medical University, Taipei, 110, Taiwan.

出版信息

J Med Syst. 2015 Mar;39(3):29. doi: 10.1007/s10916-015-0195-5. Epub 2015 Feb 13.

Abstract

Obstructive sleep apnea (OSA) is a relatively common disease in the general population. Patients with OSA have a high risk of various comorbid medical diseases. Polysomnography (PSG) is the current gold standard for diagnosing OSA but is time consuming and expensive. This study aims to identify a sensitive screening parameter that can be used by clinicians to determine the time of referral for PSG examination in Taiwan. Eighty-seven patients, including 67 males and 20 females, were included in this study. We divided the patients into two groups: training data (n = 58) and testing group (n = 29). Pearson χ(2) test was used to perform bivariate analysis, and a decision tree was used to build a model. The decision model selected the frequency of desaturation > 4% per hour (DI4) as the indicator of OSA influence. The testing data accuracy of the C4.5 decision tree was 82.80%. External data were also used to validate the model reliability. The accuracy of the external data was 95.96%. Approximately one-third of patients with DI4 between 11 and 33 suffered from OSA. This population requires further diagnosis. Oximetry is an important and widely available screening method in Taiwan. This study proposes the need for PSG referral if DI4 is between 11 and 33.

摘要

阻塞性睡眠呼吸暂停(OSA)在普通人群中是一种相对常见的疾病。OSA患者患各种合并内科疾病的风险很高。多导睡眠图(PSG)是目前诊断OSA的金标准,但耗时且昂贵。本研究旨在确定一个敏感的筛查参数,供临床医生用于确定台湾地区患者进行PSG检查的转诊时机。本研究纳入了87例患者,包括67例男性和20例女性。我们将患者分为两组:训练数据组(n = 58)和测试组(n = 29)。采用Pearson χ(2)检验进行双变量分析,并使用决策树构建模型。该决策模型选择每小时血氧饱和度下降>4%的频率(DI4)作为OSA影响的指标。C4.5决策树的测试数据准确率为82.80%。还使用外部数据验证模型的可靠性。外部数据的准确率为95.96%。DI4在11至33之间的患者中约三分之一患有OSA。这部分人群需要进一步诊断。在台湾,脉搏血氧测定法是一种重要且广泛可用的筛查方法。本研究提出,如果DI4在11至33之间,则需要进行PSG转诊。

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