Duchna H W, Rasche K, Orth M, Schultze-Werninghaus G
BG-Krankenanstalten Bergmannsheil, Universitätsklinik, Ruhr-Universität Bochum.
Pneumologie. 1995 Mar;49 Suppl 1:113-5.
As there is a great demand for polysomnography, screening tests had to be established in the diagnosis of sleep-related disordered breathing. Oxygen saturation is often used as a main diagnostic criterion of these screening tests. In 207 patients (42 women, 165 men) suspected to suffer from a sleep apnea-syndrome we compared oxygen saturation (pulse oxymetry) with apnea-hypopnea-index (AHI, polysomnography). An AHI > or = 5/h and a minimal oxygen saturation < 90% and/or more than 5 oxygen desaturations/h > or = 4% were regarded as pathological. We found a good correlation of significant oxygen desaturations measured with pulse oxymetry and AHI (r = 0.85). Compared to AHI, pulse oxymetry was seen as a sensitive method (sensitivity 0.97) to recognize sleep apnea-patients. Coincidence of COPD decreased specificity of pulse oxymetry from 0.48 to 0.23 but had no influence on its sensitivity. 13 percent of the patients without further cardiorespiratory disease had a normal AHI (< 5/h) but a pathological pulse oxymetry. We conclude, that pulse oxymetry in combination with a positive case history is a sensitive method to recognize sleep apnea-patients. Not all sleep apnea-patients' can be diagnosed only by regarding AHI without taking oxygen saturation into account.
由于对多导睡眠图的需求很大，因此必须建立筛查测试来诊断与睡眠相关的呼吸障碍。血氧饱和度常被用作这些筛查测试的主要诊断标准。在207例疑似患有睡眠呼吸暂停综合征的患者（42名女性，165名男性）中，我们将血氧饱和度（脉搏血氧测定法）与呼吸暂停低通气指数（AHI，多导睡眠图）进行了比较。AHI≥5次/小时且最低血氧饱和度<90%和/或每小时超过5次血氧饱和度下降≥4%被视为病理性。我们发现用脉搏血氧测定法测得的显著血氧饱和度下降与AHI之间有良好的相关性（r = 0.85）。与AHI相比，脉搏血氧测定法被视为识别睡眠呼吸暂停患者的一种敏感方法（敏感性为0.97）。慢性阻塞性肺疾病（COPD）的合并症使脉搏血氧测定法的特异性从0.48降至0.23，但对其敏感性没有影响。13%没有其他心肺疾病的患者AHI正常（<5次/小时）但脉搏血氧测定法结果为病理性。我们得出结论，脉搏血氧测定法结合阳性病史是识别睡眠呼吸暂停患者的一种敏感方法。并非所有睡眠呼吸暂停患者仅通过考虑AHI而不考虑血氧饱和度就能被诊断出来。
