Chen Y Y, Peng M H, Dong X S, Zhao R, Sun M Z, Gu J H, Zhang X L, Zhao L, Zhou B, Wu L B, Wang W H, Han F
Institute of Medical Technology, Peking University Health Science Center, Beijing 100083, China.
Department of Respiratory and Sleep Medicine, Peking University People' s Hospital, Beijing 100044, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Jun 12;47(6):529-534. doi: 10.3760/cma.j.cn112147-20231113-00306.
To evaluate the application value of portable pulse oximeter in adult obstructive sleep apnea (OSA). This study prospectively enrolled adult patients who underwent polysomnography (PSG) due to snoring at the Respiratory and Sleep Medicine Department of Peking University People's Hospital from July 2022 to July 2023. During PSG monitoring, CS-WOxi was continuously used to monitor blood oxygen levels. The consistency between 3% oxygen desaturation index (ODI) measured by portable pulse oximeter and ODI of polysomnography was evaluated using difference test, Pearson's correlation coefficient, and Bland-altman method. Receiver operating characteristic curve was used to determine the optimal threshold for diagnosing OSA. A total of 184 subjects were included, including 121 males (65.8%) and 63 females (34.2%). The mean age was 46.0 (34.3, 59.0) years, body mass index was 26.0 (23.3, 29.6) kg/m², and the apnea-hypopnea index was 18.2 (5.8, 40.8) events/h. There was a significant difference between CS-ODI and PSG-ODI [17.1(6.2, 42.7) 14.0(2.9, 32.6), <0.001], and the Pearson correlation coefficient was 0.93 (<0.001). There was a good correlation between CS-ODI and PSG-AHI (=0.92, <0.001). Bland-Altman consistency test showed that the average difference between the two was 0.7 events/h, and the 95% consistency limit was (-17.9, 19.3 events/h). When the CS-ODI≥5 events/h was used to identify OSA, the sensitivity was 94.4%, the specificity was 80.0%, and the accuracy was 91.3%. When PSG-AHI≥5 events/h was used as the diagnostic criteria, the area under the receiver operating characteristic curve was 0.933. Portable pulse oximeter can monitor pulse oxygen saturation accurately and has good sensitivity and specificity for OSA high-risk patients, and is a reliable tool for OSA screening.
评估便携式脉搏血氧仪在成人阻塞性睡眠呼吸暂停(OSA)中的应用价值。本研究前瞻性纳入了2022年7月至2023年7月期间因打鼾在北京大 学人民医院呼吸与睡眠医学科接受多导睡眠图(PSG)检查的成年患者。在PSG监测期间,持续使用CS-WOxi监测血氧水平。采用差异检验、Pearson相关系数和Bland-Altman方法评估便携式脉搏血氧仪测量的3%氧饱和度下降指数(ODI)与多导睡眠图ODI之间的一致性。采用受试者工作特征曲线确定诊断OSA的最佳阈值。共纳入184名受试者,其中男性l21名(65.8%),女性63名(34.2%)。平均年龄为46.0(34.3,59.0)岁,体重指数为26.0(23.3,29.6)kg/m²,呼吸暂停低通气指数为18.2(5.8,40.8)次/h。CS-ODI与PSG-ODI之间存在显著差异[17.1(6.2,42.7)对14.0(2.9,32.6),P<0.001],Pearson相关系数为0.93(P<0.001)。CS-ODI与PSG-AHI之间存在良好的相关性(r=0.92,P<0.001)。Bland-Altman一致性检验显示,两者的平均差异为0.7次/h,95%一致性界限为(-17.9,19.3次/h)。当CS-ODI≥5次/h用于识别OSA时,敏感性为94.4%,特异性为80.0%,准确性为91.3%。当以PSG-AHI≥5次/h作为诊断标准时,受试者工作特征曲线下面积为0.933。便携式脉搏血氧仪可准确监测脉搏血氧饱和度,对OSA高危患者具有良好的敏感性和特异性,是一种可靠的OSA筛查工具。