基于反射式光电容积脉搏波描记法的指环脉搏血氧饱和度仪与多导睡眠图检测中国成年人阻塞性睡眠呼吸暂停的比较：一项初步研究

Comparison of Ring Pulse Oximetry Using Reflective Photoplethysmography and PSG in the Detection of OSA in Chinese Adults: A Pilot Study.

作者信息

Zhao Rui, Xue Jianbo, Zhang Xueli, Peng Maohuan, Li Jing, Zhou Bing, Zhao Long, Penzel Thomas, Kryger Meir, Dong Xiao Song, Gao Zhancheng, Han Fang

机构信息

Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, People's Republic of China.

Sleep Medicine Center, Charité-Universitätsmedizin, Berlin, Germany.

出版信息

Nat Sci Sleep. 2022 Aug 18;14:1427-1436. doi: 10.2147/NSS.S367400. eCollection 2022.

OBJECTIVE

A novel ring-worn oximeter (Circul) uses reflective photoplethysmography and automated signal processing to calculate oxygen desaturations. We evaluated the ability of Circul to detect obstructive sleep apnea in Chinese adults.

METHODS

We recruited 207 Chinese Han subjects: 70% males, mean age 48.2±14.7 years, mean BMI 27.6±4.8 kg/m2 and mean AHI 28.6±25.2 events/h. All participants underwent simultaneous polysomnography (PSG) and Circul testing in a sleep laboratory. Oxygen desaturation index (ODI), mean oxygen saturation (MSpO), cumulative time at SpO2<90% (CT90), cumulative percentage of sleep time spent with SpO2<90% (CT90/TST) were derived and compared for the Circul and the PSG.

RESULTS

The ODI was 25.3±24.5 events/h using PSG and 22.2±24.5 events/h using Circul (P<0.0001), with an intraclass correlation coefficient (ICC) of 0.884. CT90 and CT90/TST between the two methods were not different; the MSpO level calculated by PSG was slightly lower than Circul, 95.0% (93.0-96.0%) vs 95.3% (93.9-96.6%), P<0.0001. Circul-ODI had a good correlation (r=0.91, p<0.0001) and close agreement with PSG-AHI (Bland-Altman analysis: Mean Difference 6.4, 95% CI -14.8 to 27.5 events/h). Using a threshold of AHI ≥5 events/h, the Circul had 87% sensitivity, 83% specificity, 5.09 positive likelihood ratio (LR+), 86% accuracy, and 0.929 area under the curve (AUC).

CONCLUSION

Circul ring pulse oximetry can detect OSA with reasonable reliability. The Circul system is a reliable and comfortable choice for OSA assessment.

目的

一种新型指环式血氧仪（Circul）采用反射式光电容积描记法和自动信号处理来计算氧饱和度下降情况。我们评估了Circul检测中国成年人阻塞性睡眠呼吸暂停的能力。

方法

我们招募了207名中国汉族受试者：男性占70%，平均年龄48.2±14.7岁，平均体重指数27.6±4.8kg/m²，平均呼吸暂停低通气指数（AHI）为28.6±25.2次/小时。所有参与者在睡眠实验室同时进行多导睡眠图（PSG）和Circul检测。得出并比较Circul和PSG的氧饱和度下降指数（ODI）、平均血氧饱和度（MSpO）、血氧饱和度<90%时的累计时间（CT90）、血氧饱和度<90%的睡眠时间占总睡眠时间的累计百分比（CT90/TST）。

结果

PSG测得的ODI为25.3±24.5次/小时，Circul测得的ODI为22.2±24.5次/小时（P<0.0001），组内相关系数（ICC）为0.884。两种方法测得的CT90和CT90/TST无差异；PSG计算出的MSpO水平略低于Circul，分别为95.0%（93.0 - 96.0%）和95.3%（93.9 - 96.6%），P<0.0001。Circul - ODI与PSG - AHI具有良好的相关性（r = 0.91，p<0.0001）且一致性良好（Bland - Altman分析：平均差异6.4，95%可信区间-14.8至27.5次/小时）。使用AHI≥5次/小时的阈值时，Circul的灵敏度为87%，特异度为83%，阳性似然比（LR+）为5.09，准确率为86%，曲线下面积（AUC）为0.929。