摘要目的 检验腕表式睡眠监测仪(watch peripheral arterial tone,Watch PAT)诊断睡眠呼吸暂停低通气综合征(OSAHS)的准确性及其影响因素.方法 35例以睡眠打鼾为主诉的门诊患者同时行Watch PAT监测和多道睡眠监测(PSG).PSG监测的结果由同一位有经验的技师人工分析,Watch PAT的结果则由软件自动分析.结果 35例研究对象PSG的睡眠呼吸暂停低通气指数(AHI)有高于Watch PAT AHI的趋势(P=0.06),但两者之间相关性较好,相关系数(r)可达0.955(P＜0.001).通过Watch PAT的AHI来预测PSG AHI的线性回归得到的结果为AHI (PSG)=0.944+1.030AHI( Watch PAT),P＜0.001.以PSG监测的AHI≥5次/h做为OSAHS的诊断标准,利用ROC曲线考察Watch PAT的诊断效率,所得到的曲线下面积可达0.953(P ＜0.001)；以Watch PAT监测的AHI值8.65次/h作为界值,诊断的敏感性和特异性分别为92.3％和100.0％.以AHI( Watch PAT)和AHI(PSG)差值绝对值作为分组标准,差值≥5次/h患者的体质量指数(BMI)有大于差值＜5次/h患者BMI的趋势(P=0.077).结论 Watch PAT诊断OSAHS有较高的准确性,可以作为诊断OSAHS的一种简单可靠的检测工具,但对于BMI较大的患者其诊断的准确性可能较差.

abstractsObjective This study aimed to test the accuracy of the watch peripheral arterial tone (Watch PAT) in diagnosing the obstructive sleep apnea hypopnea syndrome (OSAHS) and its influencing factors.Methods Thirty five outpatients who had a chief complaining of sleep snoring were recruited to receive Watch PAT test and polysomnography (PSG) simultaneously. The results of PSG were manually analyzed by an experienced technician,while the results of Watch PAT were automatically analyzed by software.Results There was a trend that the apnea hypopnea index (AHI) of PSG was significantly higher than that of Watch PAT (P =0.06 ) in the 35 patients studied,however,these two variables were significantly correlated ( P ＜ 0.001 ),and the correlation coefficient was as high as 0.955. A linear regression analysis which used the AHI of Watch PAT to predict the AHI of PSG also concluded same result and the equation was AHI(PSG) =0.944 + 1.030AHI( Watch PAT),P ＜0.001.The analysis which used ROC curve to test the diagnostic efficiency of Watch PAT concluded that the area under the curve could reach to 0.953 (P ＜0.001 ),and if an AHI (Watch PAT) threshold of ≥8.65 was used as the cut-off point in this study,the sensitivity and specificity could reach to 92.3％ and 100.0％.The absolute values of the differences (AVD) between the AHI of Watch PAT and the AHI of PSG were also calculated as a criterion for grouping the 35 patients studied,then it could be found that there was a trend that the BMI of patients who had an AVD≥5 were higher than that of patients who had an AVD ＜ 5 (P =0.077).Conclusions The Watch PAT is highly sensitive in the diagnosis of OSAHS,it can be used as a simple and reliable method for screening people with suspicious OSAHS. However,the accuracy of diagnosis may be relatively low in patients who have a great BMI.