经口鼻热气流传感器、鼻压传感器、呼吸阻抗容积描记法和气管音传感器检测呼吸暂停的比较。
Comparison of Apnea Detection Using Oronasal Thermal Airflow Sensor, Nasal Pressure Transducer, Respiratory Inductance Plethysmography and Tracheal Sound Sensor.
机构信息
Research and Development at CIDELEC, Sainte Gemmes, France.
Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
出版信息
J Clin Sleep Med. 2019 Feb 15;15(2):285-292. doi: 10.5664/jcsm.7634.
STUDY OBJECTIVES
Evaluation of apnea detection using a tracheal sound (TS) sensor during sleep in patients with obstructive sleep apnea.
METHODS
Polysomnographic recordings of 32 patients (25 male, mean age 66.7 ± 15.3 years, and mean body mass index 30.1 ± 4.5 kg/m) were analyzed to compare the detection of apneas by four different methods of airflow signals: oronasal thermal airflow sensor (thermistor), nasal pressure transducer (NP), respiratory inductance plethysmography (RIPsum) and TS. The four used signals were scored randomly and independently from each other according to American Academy of Sleep Medicine rules. Results of apnea detection using NP, RIPsum and TS signals were compared to those obtained by thermistor as a reference signal.
RESULTS
The number of apneas detected by the thermistor was 4,167. The number of apneas detected using the NP was 5,416 (+29.97%), using the RIPsum was 2,959 (-29.71%) and using the TS was 5,019 (+20.45%). The kappa statistics (95% confidence interval) were 0.72 (0.71 to 0.74) for TS, 0.69 (0.67 to 0.70) for NP, and 0.57 (0.55 to 0.59) for RIPsum. The sensitivity/specificity (%) with respect to the thermistor were 99.23/69.27, 64.07/93.06 and 96.06/76.07 for the NP, RIPsum and TS respectively.
CONCLUSIONS
With the sensor placed properly on the suprasternal notch, tracheal sounds could help detecting apneas that are underscored by the RIPsum and identify apneas that may be overscored by the NP sensor due to mouth breathing. In the absence of thermistor, TS sensors can be used for apnea detection.
CLINICAL TRIAL REGISTRATION
Registry: German Clinical Trials Register (DRKS), Title: Using the tracheal sound probe of the polygraph CID102 to detect and differentiate obstructive, central, and mixed sleep apneas in patients with sleep disordered breathing, Identifier: DRKS00012795, URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012795.
研究目的
评估在阻塞性睡眠呼吸暂停患者睡眠期间使用气管音（TS）传感器进行呼吸暂停检测。
方法
对 32 例患者（25 例男性，平均年龄 66.7±15.3 岁，平均体重指数 30.1±4.5kg/m）的多导睡眠图记录进行分析，比较四种不同气流信号（口鼻热气流传感器（热敏电阻）、鼻压传感器（NP）、呼吸感应体积描记法（RIPsum）和 TS）对呼吸暂停的检测。四个使用的信号随机独立评分，彼此之间互不影响，根据美国睡眠医学学会规则进行评分。NP、RIPsum 和 TS 信号检测到的呼吸暂停结果与热敏电阻作为参考信号的结果进行比较。
结果
热敏电阻检测到的呼吸暂停次数为 4167 次。NP 检测到的呼吸暂停次数为 5416 次（增加 29.97%），RIPsum 检测到的呼吸暂停次数为 2959 次（减少 29.71%），TS 检测到的呼吸暂停次数为 5019 次（增加 20.45%）。TS 的 Kappa 统计量（95%置信区间）为 0.72（0.71 至 0.74），NP 为 0.69（0.67 至 0.70），RIPsum 为 0.57（0.55 至 0.59）。NP、RIPsum 和 TS 相对于热敏电阻的灵敏度/特异性（%）分别为 99.23/69.27、64.07/93.06 和 96.06/76.07。
结论
将传感器正确放置在胸骨上切迹处，气管音可帮助检测到 RIPsum 掩盖的呼吸暂停，并识别由于口呼吸而可能被 NP 传感器高估的呼吸暂停。在没有热敏电阻的情况下，可以使用 TS 传感器进行呼吸暂停检测。
临床研究注册
德国临床试验注册处（DRKS），标题：使用多导睡眠图 CID102 的气管音探头检测和区分睡眠呼吸障碍患者的阻塞性、中枢性和混合性睡眠呼吸暂停，标识符：DRKS00012795，网址：https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012795。
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