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第45卷第1期                 谢 葵,郭 华,崔小川. 夜间间歇性缺氧相关评估指标的研究进展[J].
                  2025年1月                     南京医科大学学报(自然科学版),2025,45(1):91-97,126                      · 95  ·


                                                                  算法及机器学习,收集睡眠呼吸暂停持续时长、氧
                3  总结与展望
                                                                  饱和度降低的严重程度、AHI、ODI、MinSpO2、T90、
                    OSA 所造成的夜间 IH 通常包括呼吸事件相关                      觉醒指数等多导睡眠监测中获取的客观数据及
                氧去饱和发生的频率、持续时间和低氧幅度 3 个方                          Epworth 嗜睡量表、STOP⁃Bang 问卷等主观数据,采
                面。然而,无论从表征频率(如 ODI)、持续时间                          用数学建模的方式构建新的计算公式。另外,各种
               (T90、SIT、DesDur)、低 氧 幅 度(MinSpO2、ODR 与             计算IH程度的方法尚处于萌芽阶段,需要利用目前
                ORR等)的单一指标还是综合性的夜间IH相关评估                          公开的数据库进行大数据、多中心的临床验证。此
                指标(如 HB、HBI、HL、ObsSev、SBII 等)都无法对夜                外,为了使IH的评估指标能更好地反映OSA的病理
                间IH进行客观精确而全面地评估。各种IH相关指                           生理特征以及疾病负担,也可考虑结合心肺功能检
                标用于评估夜间 IH 的程度都存在各自的优势和缺                          测、血清标志物等数据进行综合评估。综上所述,
                陷(表2),且缺乏多中心的验证,限制了其临床应用                          如何寻找更精确的评估指标用于评价夜间 IH 的严
                及推广。因此,需要进一步寻找更准确、全面且易                            重程度,是当前睡眠医学领域的一个重要研究方
                于应用的评估指标及方法。为了更加精确地计算                             向,对提高相关疾病的诊断和治疗水平具有重要指
                IH负荷,或许可考虑借助先进的人工智能数据分析                           导意义。


                                                表2 IH相关评估指标的临床应用及缺陷
                                Table 2  Clinical applications and deficiencies of IH⁃related assessment indicators
                    Categorization   Indicator     Complication associated with OSA          Deficiency
                Desaturation frequency  ODI    CVD                               Controversial definition of desaturation by
                                                                                 describing only the frequency of the IH
                Desaturation duration  T90     CVD,type 2 diabetes,and COPD      Only the duration of IH is described,ig⁃
                                       SIT     Severity of nocturnal hypoxia in OSA  noring the effect of the degree of oxygen
                                     DesDur    Myocardial injury,and heart failure mortality  drop
                Desaturation depth   MinSpO2   EDS,diabetes mellitus,cognitive ability,  Reflecting only the depth of IH and re⁃
                                               CVD outcomes,and post⁃UPPP adverse events  sults are susceptible to device accuracy
                                   ODR and ORR Hypertension,and EDS              and patient movement
                Synthesis              HB      CVD mortality,venous thrombosis piece,  All of them can only be obtained indirectly
                                               and stroke risk stratification    from PSG,and the calculation methods
                                       HBI     CVD                               have not yet been unified,therefore,they
                                       HL      Myocardial infarction,and abnormal glucose  are currently only used in scientific re⁃
                                               metabolism                        search,and multi⁃center and big data stud⁃
                                      SBII     Incidence of CVD                  ies are still needed to explore their accu⁃
                                     ObsSev    CVD outcomes,impaired vigilance,and EDS  racy and clinical value
                   SIT:saturation impairment time;DesDur:desaturation duration;ODR:oxygen desaturation rate;ORR:oxygen resaturation rate.

                   利益冲突声明:
                                                                 [参考文献]
                   所有作者声明无利益冲突。
                   Conflict of Interests:                        [1] BERRY R B,BUDHIRAJA R,GOTTLIEB D J,et al.
                                                                       Rules for scoring respiratory events in sleep:update of the
                   All authors declare no conflict of interests.
                   作者贡献声明:                                             2007 AASM Manual for the Scoring of Sleep and Associat⁃
                   谢葵负责研究计划推进、论文撰写与修改;郭华负责资料                           ed Events. Deliberations of the sleep apnea definitions
                分析、论文撰写与修改;崔小川负责研究方向指导、论文修改。                           task force of the American Academy of Sleep Medicine[J].
                   Author’s Contributions:                             J Clin Sleep Med,2012,8(5):597-619

                   XIE Kui was responsible for research plan progress,paper  [2] THANAVIRATANANICH S,CHENG H,CHIRAKAL⁃
                writing and revision;GUO Hua was responsible for data analy⁃  WASAN N,et al. Association between nocturnal hypox⁃
                sis,paper writing and revision;CUI Xiaochuan was responsi⁃  emic burden and glucose metabolism[J]. Sleep Breath,
                ble for research direction guidance and paper revision.  2022,26(3):1465-1470
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