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目的脉搏传导时间(PTT)是一项反映周围血管阻力和胸腔内压变化的无创指标,因此和微觉醒相关的血压改变可通过PTT检测。本文评估PTT微觉醒能否作为阻塞性睡眠呼吸暂停低通气综合征患者睡眠片断的指标。方法选择疑诊有睡眠呼吸障碍者39例,使用Rembrandt和HypnoPTT睡眠监测系统进行同步夜间睡眠呼吸监测,监测前进行ESS(epworth sleepiness scale)嗜睡评分。对三项常规判断睡眠片断的客观指标:脑电图(EEG)微觉醒指数、呼吸暂停低通气量指数(AHI)、氧减指数(ODI)和反映嗜睡的主观指标ESS评分,同PTT微觉醒指数进行比较。结果PTT微觉醒指数和EEG微觉醒指数之间呈正相关(r=0.725,P<0.01);PTT微觉醒指数、EEG微觉醒指数分别与呼吸事件(AHI、ODI)之间呈正相关(r=0.791;r=0.670;r=0.755;r=0.765,P分别小于<0.01)。而PTT微觉醒指数和EEG微觉醒指数与ESS评分之间相关性较差(r=0.449;r=0.196,P分别>0.01)。结论PTT微觉醒和反映阻塞性睡眠呼吸暂停低通气患者睡眠片断的其他指标密切相关,可作为判断睡眠片断的一项简单而准确的客观指标。
PURPOSE The pulse transit time (PTT) is a noninvasive measure of peripheral vascular resistance and changes in intrathoracic pressure and therefore changes in blood pressure associated with arousal can be detected by PTT. This article assesses whether PTT waking can be used as an indicator of sleep quality in patients with obstructive sleep apnea-hypopnea syndrome. Methods Thirty-nine patients with suspected sleep-disordered breathing were selected. Synchronized night-time respiration monitoring was performed using the Rembrandt and HypnoPTT sleep-monitoring systems and the ESS (sleepiness scale for sleepiness) score was monitored before monitoring. The objective indexes for judging three sleep segments: electroencephalogram (EEG) arousal index, apnea hypopnea index (AHI), oxygen reduction index (ODI) and ESS scores of subjective indicators reflecting drowsiness, Index for comparison. Results There was a positive correlation between the arousal index and EEG arousal index (r = 0.725, P <0.01). There was a positive correlation between PTZ arousal index and EEG arousal index (AHI, ODI) ; r = 0.670; r = 0.755; r = 0.765, respectively, P <0.01). The correlation between PTT arousal index and EEG arousal index and ESS score was poor (r = 0.449; r = 0.196, P> 0.01). Conclusions There is a close relationship between arousals of PTT and other indexes reflecting sleep segments in patients with obstructive sleep apnea hypopnea, which can be used as a simple and accurate objective index for judging sleep segments.