通过心率可变性分析查阻塞性睡眠呼吸暂停综合征
F Roche1, J M Gaspoz, I Court-Fortune
1Service d'Exploration Fonctionnelle CardioRespiratoire, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France. Frederic.Roche@univ-st-etienne.fr
Circulation
|September 29, 1999
概括
心率变化 (HRV) 分析,特别是白天和夜间值 (Delta[D/N]) 之间的差异,显示了检测阻塞性睡眠呼吸暂停综合征 (OSAS) 的前景. 这种方法可以准确地选患者,识别那些最有OSAS风险的人.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 生物医学工程 生物医学工程
背景情况:
- 夜间心率变化 (HRV) 在与睡眠相关的呼吸障碍中发生变化.
- 阻塞性睡眠呼吸暂停综合征 (OSAS) 的HRV诊断能力需要系统评估.
研究的目的:
- 评估HRV参数的辨别力,以检测OSAS.
- 在独立的患者队列中验证研究结果.
主要方法:
- 从两个患者组 (G1和G2) 收集HRV数据.
- 计算的时间域HRV变量 (SDNN,SDNN指数,r-MSSD,SDANN) 用于白天,夜间和Delta[D/N]时期.
- 使用了接收器运行特征 (ROC) 曲线和物流回归来分析G1.
- 在G2中使用分类和回归树方法验证的结果.
主要成果:
- 德尔塔[D/N]SDNN指数和德尔塔[D/N]r-MSSD是G1中OSAS的显著独立预测因素 (分别为ORs8.22和2.86).
- 分类和回归树分析显示,高灵敏度 (89.7%) 和特异性 (98.1%) 对G1.1中的Delta[D/N] SDNN指数和Delta[D/N] SDNN.
- 在G2的验证证实了这些HRV参数的高灵敏度 (83%) 和特异性 (96.5%).
结论:
- 时间域HRV分析,特别是Delta[D/N]指标,为疑似OSAS提供了准确且具有成本效益的查方法.
- 这种方法可以帮助将资源优先分配给高风险人群.
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