Parra O, García-Esclasans N, Montserrat J M, García Eroles L, Ruíz J, López J A, Guerra J M, Sopeña J J
Servei de Pneumologia, Hospitals de Barcelona (Quinta Salut Alianca), Spain.
Eur Respir J. 1997 Aug;10(8):1720-4. doi: 10.1183/09031936.97.10081720.
The purpose of this study was to analyse the validity and the economic efficiency of a portable monitor of respiratory parameters (PMRP), used in a home setting for the diagnosis of sleep apnoea/hypopnoea syndrome (SAHS). Eighty nine patients with suspected SAHS were studied in two settings: in the sleep laboratory using full-polysomnography (full-PSG); and at the patient's home using a PMRP. In the home setting, 50 patients were assisted by a technician and 39 set up the equipment themselves. SAHS (apnoea/hypopnoea index (AHI) >10 events x h(-1) by means of full-PSG) was diagnosed in 75 of the 89 patients. An acceptable agreement was obtained between the AHI measured by full-PSG and PMRP, according to the Bland and Altman method of concordance (mean bias 2.56; 95% confidence interval 3.25). Sensitivity and specificity of PMRP were adequate for diagnostic purposes; however, their values rely on the prior PMRP-AHI cut-off point selected with reference to full-PSG-AHI >10. The clinical therapeutic decision taken after PMRP agreed with that taken with full-PSG in 79 patients (89%). Although 10% of the studies with an individual set-up needed repetition, both of the domiciliary modalities (with and without a technician's intervention) were, economically, about three times more efficient than full-PSG. In conclusion, we believe that patients with a suspected sleep apnoea/hypopnoea syndrome should initially be studied in a home setting with a portable monitor of respiratory parameters, since it is a reliable method with an acceptable cost-effective profile.
本研究旨在分析一种便携式呼吸参数监测仪（PMRP）在家庭环境中用于诊断睡眠呼吸暂停/低通气综合征（SAHS）的有效性和经济效益。89例疑似SAHS的患者在两种环境下接受研究：在睡眠实验室采用全夜多导睡眠图（全夜PSG）；在患者家中使用PMRP。在家庭环境中，50例患者由技术人员协助，39例患者自行安装设备。通过全夜PSG诊断出89例患者中有75例患有SAHS（呼吸暂停/低通气指数（AHI）>10次事件×小时⁻¹）。根据Bland和Altman一致性方法，全夜PSG测量的AHI与PMRP之间获得了可接受的一致性（平均偏差2.56；95%置信区间3.25）。PMRP的敏感性和特异性对于诊断目的而言是足够的；然而，它们的值依赖于参照全夜PSG - AHI >10所选择的先前PMRP - AHI截断点。PMRP后做出的临床治疗决策与全夜PSG后做出的决策在79例患者（89%）中一致。尽管10%的自行安装设备的研究需要重复，但两种家庭模式（有和没有技术人员干预）在经济上比全夜PSG效率大约高三倍。总之，我们认为疑似睡眠呼吸暂停/低通气综合征的患者最初应在家庭环境中使用便携式呼吸参数监测仪进行研究，因为这是一种可靠的方法，具有可接受的性价比。
