Kehrer P, Nicod L P
Division de pneumologie, Hôpital cantonal universitaire de Genève.
Schweiz Rundsch Med Prax. 1994 Sep 13;83(37):1039-43.
Sleep apnea syndrome (SAS) consists of nocturnal snoring interrupted by obstructive apnea and of diurnal symptoms like hypersomnolence as a consequence of sleep fragmentation. Cardiovascular morbidity and mortality associated with this syndrome justify early detection and appropriate treatment. Polysomnography is still a frequently used method for early detection; however, several disadvantages like duration, discomfort and expense led to a search for alternatives. Since the beginning of the eighties, oximetry allows recording of nocturnal oxygen saturation of hemoglobin even at home. Nocturnal oximetry reveals O2-desaturation associated with apnea and thus permits often to diagnose or exclude SAS. Diagnosis of SAS is made when at least 20 desaturations per hour with an amplitude of at least 4% are recorded. On the other hand, normal nocturnal oximetry nearly excludes SAS. In those cases where nocturnal oximetry is not diagnostic, polysomnography remains the method of choice. Departing from published work, a model for SAS detection, based mainly on nocturnal oximetry, is proposed.
睡眠呼吸暂停综合征（SAS）表现为夜间打鼾被阻塞性呼吸暂停打断，以及因睡眠片段化导致的日间症状，如嗜睡。与该综合征相关的心血管发病率和死亡率使得早期检测和适当治疗成为必要。多导睡眠图仍然是早期检测常用的方法；然而，其持续时间、不适感和费用等诸多缺点促使人们寻找替代方法。自20世纪80年代初以来，血氧测定法甚至可以在家中记录夜间血红蛋白氧饱和度。夜间血氧测定可揭示与呼吸暂停相关的氧饱和度下降，因此常常能够诊断或排除SAS。当每小时记录到至少20次幅度至少为4%的氧饱和度下降时，即可诊断为SAS。另一方面，夜间血氧测定正常几乎可排除SAS。在夜间血氧测定无法诊断的情况下，多导睡眠图仍是首选方法。基于已发表的研究成果，本文提出了一种主要基于夜间血氧测定的SAS检测模型。
