动态心电图初筛儿童阻塞性睡眠呼吸暂停低通气综合征研究

发布时间：2018-04-10 09:50

本文选题：阻塞性睡眠呼吸暂停低通气综合征　切入点：心率变异性　出处：《中国实用儿科杂志》2014年06期

【摘要】：目的探讨应用动态心电图(AECG)的心率变异性(HRV)对儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)初筛的可行性。方法收集首都医科大学附属北京儿童医院2012年3月至9月间年龄3岁以上的睡眠打鼾儿童,在进行睡眠监测(PSG)的同时进行连续24h AECG监测。根据PSG结果分别作出有无OSAHS的诊断,通过比较OSAHS与非OSAHS患儿HRV的差异,通过受试者工作特性曲线(ROC)法得出敏感指标及临界值作为初筛标准。评价应用HRV初筛OSAHS的可行性。结果 OSAHS患儿与非OSAHS相比,SDNNall day、SDANNall day、PNN50night、LF/HFnight及PNN50day-night差异均有统计学意义;用ROC法得到SDNNall day≤95.5 ms、SDANNall day≤80.5 ms、PNN50night≤24.6%、LF/HFnight≥0.845及PNN50day-night的绝对值≤24.55 ms为最佳初筛界值。联合应用5项指标(积分法)来初筛OSAHS,ROC曲线下面积(AUC)最大为0.695。结论 HRV作为评估OSAHS是否存在自主神经功能失调的指标,有望成为一种初筛OSAHS的方法。
[Abstract]:Objective to investigate the feasibility of HRV for OSAHS in children with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Sleep snoring children who were over 3 years old in Beijing Children's Hospital affiliated to Capital Medical University from March to September 2012 were collected and monitored for 24 hours simultaneously with sleep monitoring.The diagnosis of OSAHS was made according to the results of PSG. By comparing the difference of HRV between OSAHS and non-#en3# children, the sensitive index and critical value were obtained by means of the method of operating characteristic curve.To evaluate the feasibility of using HRV to screen OSAHS.The maximum area under the ROC curve of OSAHS was 0.695.Conclusion HRV can be used as an index to evaluate the autonomic nervous dysfunction in OSAHS, and it is expected to be a preliminary screening method for OSAHS.
【作者单位】：首都医科大学附属北京儿童医院呼吸内科;首都医科大学附属北京儿童医院心脏中心;
【分类号】：R766

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