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引用次数: 0
摘要
近年来,新型 III 型和 IV 型便携式睡眠监测仪(PSM)层出不穷,但有关其在儿童中使用的诊断准确性的证据仍然参差不齐。本研究系统回顾了有关 III 型和 IV 型便携式睡眠监测仪对儿童睡眠呼吸暂停诊断准确性的文献。采用 PRISMA 框架对 Medline、Embase 或 Web of Science 索引的文献进行了审查。在 1054 项研究中,有 62 项符合纳入标准。在对基于血氧仪的 IV 型 PSM 进行评估的研究中,有一项研究(6.25%)对任何小儿睡眠呼吸暂停的诊断都显示出了一组均衡的高(≥80%)灵敏度和特异性,而有五项研究(27.8%)对中度至重度睡眠呼吸暂停显示出了类似的准确性。对于非氧饱和度测量法的 IV 型 PSM,有两项研究(40%)对中度至重度睡眠呼吸暂停的诊断准确率较高。III 型 PSM 的诊断准确率较高,有六项研究(66.7%)报告了中重度睡眠呼吸暂停的高诊断准确率。本综述强调了 III 型 PSM 检测中重度儿科睡眠呼吸暂停的潜力,尽管目前的证据有限,不足以支持单独使用 IV 型 PSM 诊断大多数儿童的睡眠呼吸暂停。
Diagnostic accuracy of portable sleep monitors in pediatric sleep apnea: A systematic review
In recent years, a plethora of new type III and IV portable sleep monitors (PSM) have been developed, although evidence regarding their diagnostic accuracy for use in children remains heterogeneous. This study systematically reviews the literature addressing the diagnostic accuracies of type III and IV PSM for pediatric sleep apnea. Publications indexed in Medline, Embase, or Web of Science were reviewed using the PRISMA framework. Of 1054 studies, 62 fulfilled the inclusion criteria. Of the studies evaluating oximetry-based type IV PSM, one (6.25 %) demonstrated a balanced set of high (≥80 %) sensitivities and specificities for the diagnosis of any pediatric sleep apnea, while five studies (27.8 %) showed similar accuracies for moderate-to-severe sleep apnea. For non-oximetry-based type IV PSM, two studies (40 %) reported a balanced set of high diagnostic accuracies for moderate-to-severe sleep apnea. Type III PSM repeatedly demonstrated higher diagnostic accuracies, with six studies (66.7 %) reporting a balanced set of high diagnostic accuracies for moderate-to-severe sleep apnea. This review highlights the potential of type III PSM to detect moderate-to-severe pediatric sleep apnea, although current evidence is limited to support the stand-alone use of type IV PSM for the diagnosis of sleep apnea in most children.
期刊介绍:
Sleep Medicine Reviews offers global coverage of sleep disorders, exploring their origins, diagnosis, treatment, and implications for related conditions at both individual and public health levels.
Articles comprehensively review clinical information from peer-reviewed journals across various disciplines in sleep medicine, encompassing pulmonology, psychiatry, psychology, physiology, otolaryngology, pediatrics, geriatrics, cardiology, dentistry, nursing, neurology, and general medicine.
The journal features narrative reviews, systematic reviews, and editorials addressing areas of controversy, debate, and future research within the field.