便携式睡眠监测仪应用于儿童OSAHS诊断的临床分析

摘要：目的初步探讨便携式睡眠监测仪（PM）在儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的临床诊断价值。方法随机选择门诊收治的以经常性睡眠打鼾为主诉的儿童患者36例,其中男23例,女13例;年龄4~13岁,平均年龄（7.0±2.6）岁,应用PM与多导睡眠监测仪（PSG）对患儿进行整夜同步睡眠呼吸监测,同时完成儿童OSAHS疾病特异性生活质量调查表（OSA 18）,分析PM灵敏度及特异性,对比分析两种睡眠监测仪临床各参数的相关性,以及OSA 18问卷与AHI相关性。结果以PSG监测结果为标准,在儿童OSAHS 监测诊断中,根据严重程度分为单纯鼾症2例,轻度5例,中度12例,重度17例;PM分析单纯鼾症1例,轻度6例,中度10例,重度19例,PM的灵敏度为97.1%,特异度为100.0%,准确率为97.2%;两种睡眠监测仪的睡眠呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSaO2）及平均血氧饱和度（MSaO2）有相关性,OSA 18问卷与PM及PSG监测的AHI呈正相关性（r=0.875、0.874,P均<0.05）。结论PM辅以OSA 18问卷调查在儿童OSAHS中具有较高的临床诊断价值,且PM与PSG各项指标相关性良好,操作简便,值得临床推广应用。

A preliminary study on the application of portable sleep monitor in the diagnosis of OSAHS in children

ObjectivePreliminary study on the clinical diagnostic value of portable sleep monitor(PM) in children with obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsThirty six children with regular sleep snoring were randomly selected from outpatients, including 23 males and 13 females; age(4~13) years, average age (7±2.6) years old. PM and polysomnography(PSG) were used to monitor the synchronized sleep and respiratory of children with OSAHS throughout the night. At the same time, the disease specific quality of children with obstructive sleep apnea 18 items questionnaire(OSA 18) was completed to analyze the sensitivity and specificity of PM with comparing and analyzing the correlation between the clinical parameters of the two sleep monitors, and the correlation between OSA 18 questionnaire and the sleep apnea hypopnea index (AHI).ResultsAccording to the results of PSG monitoring about the severity of OSAHS in children, there were 2 cases of simple snoring, 5 cases of mild snoring, 12 cases of moderate snoring, and 17 cases of severe snoring. According to PM analysis, there were 1 case of simple snoring, 6 cases of mild snoring, 10 cases of moderate snoring, and 19 cases of severe snoring. The sensitivity, specificity and accuracy of PM were 97.1%, 100.0% and 97.2% respectively. There were correlation between AHI, lowest blood oxygen saturation (LSaO2) and average blood oxygen saturation (MSaO2) of two sleep monitors. The OSA 18 questionnaire is positively correlated with the AHI monitored by PM and PSG (r=0.875, 0.874, all P<0.05).ConclusionsPM assisted OSA 18 questionnaire has high clinical diagnostic value in children with OSAHS, and PM has a good correlation with PSG indicators. It is easy to operate and worthy of clinical application.