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摘要: 目的 评价新型碳黑聚氨酯干电极脑电临床应用的准确性，明确新型干电极脑电临床应用价值。方法 43例成年男性患者同时佩戴Ag/AgCl湿电极和新型干电极脑电进行睡眠监测，以湿电极记录为金标准，进行干电极监测结果诊断准确性分析。结果 新型干电极脑电总体的准确性为74.53%；对于不同分期，干电极的诊断效能存在较大差异；WK、N1、N2、N3和REM期敏感度分别为85.75%、61.92%、74.22%、79.70%和74.50%，特异度分别为95.54%、88.46%、88.15%、95.07%、98.55%；其中对睡眠总时间和AHI影响较大的WK期，干电极的敏感度为85.75%，特异度为95.54%。结论 干电极脑电采集准确性较好，对睡眠和清醒分期的识别干电极整体表现良好，可较为准确地记录脑电活动，有利于提高便携式睡眠监测设备对OSA疾病诊断的准确性。
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关键词:
- 睡眠呼吸暂停，阻塞性 /
- 干电极 /
- 敏感度 /
- 特异度
Abstract: Objective To evaluate the accuracy of the new carbon black polyurethane dry electrode electroencephalogram and clarify the value of the new dry electrode electroencephalogram.Method Forty-three male-adult patients in the group were wearing both Ag/AgCl wet electrode and new dry electrode for sleep monitoring. The wet electrode recording was used as the gold standard for diagnostic accuracy analysis of dry electrode monitoring results.Result The overall accuracy of the new type of dry electrode EEG was 74.53%, and the diagnostic efficiency of the dry electrode was significantly different among different stages. The sensitivity of WK, N1, N2, N3 and REM is 85.75%, 61.92%, 74.22%, 79.70% and 74.50%, and the specificity is 95.54%, 88.46%, 88.15%, 95.07%, 98.55%, respectively.Conclusion The dry electrode EEG acquisition accuracy is good, especially for the WK, which is beneficial to improve the accuracy of the portable sleep monitoring equipment for the diagnosis of OSA disease.-
Key words:
- sleep apnea, obstructive /
- dry electrode /
- sensitivity /
- specificity
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表 1 入组患者一般情况
x±s 变量 单纯打鼾组 轻度OSA组 中度OSA组 重度OSA组 P 年龄 31.11±10.90 33.14±11.64 42.33±3.37 39.15±8.84 0.91 身高 173.56±3.91 172.86±2.55 176.00±5.29 174.55±4.15 0.40 体重 25.62±4.29 25.59±4.09 28.99±2.47 28.51±4.33 0.92 BMI 76.94±11.30 76.71±14.01 90.00±11.53 87.00±14.39 0.15 颈围 40.11±2.47 40.57±3.91 43.67±2.52 43.25±3.28 0.03 ESS 5.78±3.77 7.86±4.10 4.67±4.51 7.70±4.12 0.59 血氧 0.96±0.01 0.96±0.01 0.97±0.02 0.92±0.04 < 0.01 AHI 2.07±1.33 9.33±3.19 26.43±2.8 61.56±21.84 < 0.01 
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表 2 干电极不同睡眠分期诊断效能
诊断效能 WK期 N1期 N2期 N3期 REM期 敏感度/% 85.75 61.92 74.22 79.70 74.50 特异度/% 95.54 88.46 88.15 95.07 98.55 准确度/% 94.17 84.85 81.04 94.16 94.86 假阳性率/% 4.46 11.53 5.80 4.93 1.45 假阴性率/% 14.25 38.08 25.78 20.30 25.50 阳性似然比 19.23 5.36 6.26 16.17 51.29 阴性似然比 0.15 0.43 0.29 0.21 0.26
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表 3 新型干电极判读结果
屏(%) 湿电极 干电极 合计 WK期 N1期 N2期 N3期 REM期 WK期 1065(85.75) 97(7.81) 58(4.67) 2(0.16) 20(1.61) 1242(100.00) N1期 188(15.56) 748(61.92) 207(17.14) 17(1.41) 48(3.97) 1208(100.00) N2期 138(3.05) 596(13.17) 3360(74.22) 392(8.66) 41(0.91) 4527(100.00) N3期 0(0) 0(0) 107(20.30) 420(79.70) 0(0) 527(100.00) REM期 14(1.03) 191(14.03) 142(10.43) 0(0) 1014(74.50) 1361(100.00)
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表 4 各组患者干电极脑电敏感度比较
% 组别 WK期 N1期 N2期 N3期 REM期 单纯打鼾组 93.20 61.76 69.96 78.51 89.66 轻度OSA组 80.27 40.61 80.69 88.95 69.40 中度OSA组 97.04 49.44 70.51 79.27 79.39 重度OSA组 78.39 72.60 70.62 67.91 73.77 合计 85.75 61.92 74.22 79.70 74.50
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表 5 各组患者干电极脑电特异度比较
% 组别 WK期 N1期 N2期 N3期 REM期 单纯打鼾组 97.83 92.15 92.87 94.05 98.60 轻度OSA组 97.38 95.63 79.31 91.53 98.76 中度OSA组 90.34 86.26 92.41 97.52 99.91 重度OSA组 95.50 82.78 90.11 96.23 97.92 合计 95.54 88.46 88.15 95.07 98.55
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