贵州地区阻塞性睡眠呼吸暂停的认知率及不同类型 睡眠监测仪临床应用的效果评价

Evaluation of the cognitive rate of obstructive sleep apnea in Guizhou and the clinical application of different types of sleep monitors

摘要:

通过问卷调查评估贵州地区人群对阻塞性睡眠呼吸暂停（OSA）的认知程度；同时通过观察不同类型睡眠监测仪在睡眠参数上的差异，探讨IV型便携式睡眠监护仪（PM）对OSA患者的诊断价值。方法 设计问卷在贵州进行调查；同时另随机选取116例高危OSA人群行Ⅳ型PM监测，其中随机选取101例同时行多导睡眠监测仪（PSG）同步整夜监测、15例同时行III型PM同步整夜监测，比较不同监测方法的临床参数。结果（1）在医务人员调查者中，医院等级越高、文化程度越高、职称越高，对OSA专业知识了解程度越高。（2）在非医务人员调查者中，女性、对OSA有了解的受访者更重视OSA。（3）69.7%医务人员倾向于推荐PSG监测，8.7%医务人员推荐III型PM监测，5.8%倾向于推荐便携指环初筛，4.6%选择推荐腕表式血氧监测仪初筛，11.2%医务人员不清楚推荐哪种方式合适。（4）以PSG为金标准，Ⅳ型PM的灵敏度为95.9%、特异度为66.7%、阳性预测值为97.9%、阴性预测值为57.1% ；三种睡眠监测仪对OSA病情严重程度的评估结果不同，PSG与Ⅳ型PM差异具有统计学意义（P＜0.01）。（5）Spearman等级相关分析显示Ⅳ型PM与PSG测定的AHI值、LSaO2、SIT90、SIT80呈正相关。结论 医务人员及非医务人员均对OSA专业知识认知率偏低，Ⅳ型PM对可疑OSA患者具有一定的诊断价值，但对病情严重程度的评估有差异。

Abstract:

[Summary] Objective The cognitive degree of obstructive sleep apnea (OSA) in Guizhou was evaluated by questionnaire survey. At the same time, the diagnostic value of type IV portable sleep monitor (PM) for OSA patients was discussed by observing the differences in sleep parameters of different sleep monitors. Methods The questionnaire was designed and investigated in Guizhou. At the same time, 101 patients suspected of OSA were randomly selected to use type IV PM and PSG synchronous overnight monitoring; 15 cases were simultaneously monitored overnight using type IV PM and type III PM. Then the clinical parameters of different monitoring methods were compared. Results (1) Among medical staff investigators, the higher the hospital level, the higher the education level, the higher the professional title, the higher the understanding of OSA professional knowledge. (2) Among non-medical staff respondents, women and respondents with knowledge of OSA paid more attention to OSA. (3) 69.7% of medical personnel tend to recommend PSG monitoring, while 8.7% recommend type III PM monitoring. Additionally, 5.8% tend to recommend portable ring preliminary screening, and 4.6% choose to recommend wristwatch blood oxygen monitor preliminary screening. It is worth noting that 11.2% of medical personnel do not know which method is appropriate to recommend. (4) Using PSG as the gold standard, the sensitivity of type IV PM was 95.9 %, the specificity was 66.7 %, the positive predictive value was 97.9 %, and the negative predictive value was 57.1 %. The evaluation results of the three sleep monitors on the severity of OSA were different, and the difference between PSG and type IV PM was statistically significant ( P < 0.01 ). (5) Spearman rank correlation analysis showed that type IV PM was positively correlated with AHI value, LSaO2, SIT90 and SIT80 measured by PSG. Conclusion Both medical staff and non-medical staff have a low awareness rate of OSA professional knowledgeType IV PM has a certain diagnostic value in patients with suspected OSA, but there are differences in the assessment of the severity of the disease.