Koziej M, Cieślicki J K, Gorzelak K, Sliwiński P, Zieliński J
Dept of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
Eur Respir J. 1994 Oct;7(10):1771-5. doi: 10.1183/09031936.94.07101771.
The MESAM 4 system, developed to monitor breathing sounds, heart rate, arterial oxygen saturation (Sao2) and body position, was proposed as a screening method for obstructive sleep apnoea (OSA). The aim of the study was to assess the accuracy of hand-scoring versus automatic-scoring in screening for obstructive sleep apnoea. The study population consisted of 56 patients, 51 males, and 5 females, mean age 47 +/- 10 yrs, suspected of having obstructive sleep apnoea. Full polysomnography and MESAM 4 recordings were performed simultaneously. The apnoea+hypopnoea index was hand-scored in polysomnography and in MESAM 4. The hand-scoring in MESAM 4 was based on analysis of breathing sounds, heart rate and Sao2 changes taken together. The automatic-scoring system of MESAM 4 calculated oxygen desaturation index, heart rate variation index and intermittent snoring index. The diagnosis of obstructive sleep apnoea (apnoea+hypopnoea index > or = 10) was established by polysomnography in 37 patients. Sensitivity and specificity of hand-scored MESAM 4 diagnosis were 100 and 63%, respectively. Sensitivity and specificity of MESAM 4 diagnosis with automatic-scoring were: from oxygen desaturation index 100 and 27%; from heart rate variation index 81 and 74%; and from intermittent snoring index 92 and 16%, respectively. We suggest that hand-scoring of MESAM 4 is more accurate than automatic-scoring in screening for obstructive sleep apnoea.
MESAM 4系统旨在监测呼吸音、心率、动脉血氧饱和度（Sao2）和身体姿势，被提议作为阻塞性睡眠呼吸暂停（OSA）的一种筛查方法。本研究的目的是评估在阻塞性睡眠呼吸暂停筛查中人工评分与自动评分的准确性。研究对象包括56例疑似患有阻塞性睡眠呼吸暂停的患者，其中51例男性，5例女性，平均年龄47±10岁。同时进行了全夜多导睡眠图和MESAM 4记录。在多导睡眠图和MESAM 4中对呼吸暂停+低通气指数进行人工评分。MESAM 4中的人工评分基于对呼吸音、心率和Sao2变化的综合分析。MESAM 4的自动评分系统计算氧饱和度下降指数、心率变异性指数和间歇性打鼾指数。通过多导睡眠图确诊37例阻塞性睡眠呼吸暂停患者（呼吸暂停+低通气指数≥10）。MESAM 4人工评分诊断的敏感性和特异性分别为100%和63%。MESAM 4自动评分诊断的敏感性和特异性分别为：氧饱和度下降指数为100%和27%；心率变异性指数为81%和74%；间歇性打鼾指数为92%和16%。我们认为，在阻塞性睡眠呼吸暂停筛查中，MESAM 4的人工评分比自动评分更准确。
