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目的:探讨夜间脉搏氧饱和度仪在睡眠呼吸暂停低通气综合征(SAHS)诊治中的临床应用价值。方法:对比121例打鼾者的夜间动态氧饱和度(SaO2)和夜间多导睡眠监测(PSG)结果,并根据睡眠呼吸紊乱指数(RDI)分成非SAHS组(RDI<5)16例,轻度SAHS组(5≤RDI<20)24例,中度SAHS组(20≤RDI<40)36例,重度SAHS组(RDI≥40)45例,组间进行夜间动态血氧监测指标[每小时氧饱和度下降≥4%的次数(ODI4,即氧减饱和度指数)、最低血氧饱和度(LSaO2)、平均血氧饱和度(MSaO2)、氧饱和度≤90%的时间占总监测时间的百分比(SIT90)]的比较。结果:ODI4与RDI、SIT90相关性较好(r=0.81,r=0.66,P<0.001),对RDI≥5次/h者,DI4≥5次/h的敏感性达95.1%,若以ODI4≥15次/h为标准,可以准确诊断所有的SAHS患者,组间LSaO2、SIT90、ODI4差异有统计学意义(P均<0.001)。结论:选择适当的ODI4可以提高诊断的准确性,夜间脉搏-氧饱和度仪可以成为一种替代多导睡眠监测并准确预测呼吸紊乱指数的简易方法,LSaO2、MSaO2、SIT90可以较好反应SAHS患者缺氧程度。
Objective: To investigate the clinical value of nighttime pulse oximeter in the diagnosis and treatment of sleep apnea-hypopnea syndrome (SAHS). Methods: The nocturnal dynamic oxygen saturation (SaO2) and nocturnal polysomnography (PSG) were compared among 121 snorers. According to the sleep disordered breathing index (RDI), 16 patients were divided into non-SAHS group (RDI <5) Twenty-four patients in SAHS group (5≤RDI <20), 36 in moderate SAHS group (20≤RDI <40) and 45 in severe SAHS group (RDI≥40) (ODI4, oxygen desaturation index), LSaO2, MSaO2, and oxygen saturation ≤90% of the total monitoring time Percent (SIT90)]. Results: The correlation between ODI4 and RDI and SIT90 was good (r = 0.81, r = 0.66, P <0.001). The sensitivity of ODI4 to DI5≥5 times / h was 95.1% ≥15 times / h as standard, all the patients with SAHS can be accurately diagnosed. The differences of LSaO2, SIT90 and ODI4 between the two groups were statistically significant (all P <0.001). CONCLUSIONS: Choosing the right ODI4 improves diagnostic accuracy. Nighttime pulse oximetry can be an alternative to polysomnography and accurate prediction of respiratory disturbances. LSaO2, MSaO2, and SIT90 are a good response to patients with SAHS Hypoxia level.