关键词: 睡眠呼吸暂停, 儿童, 血氧饱和度, 嗜睡量表

Abstract: Objective To evaluate the accuracy of nocturnal lowest oxygen saturation (LSaO₂ ) at night combined with OSA-18 scale and modified Epworth Sleepiness Scale for Children (ESS-CHAD ) in primary screening of obstructive sleep apnea (OSA ) in children, so as to explore a simpler, faster and feasible method for primary screening of suspected OSA in children. Methods A total of 139 children who completed overnight polysomnography (PSG) in the Department of Otolaryngology Head and Neck Surgery of Second Affiliated Hospital of Xi′an Jiaotong University were enrolled in this study from 13rd, August 2020 to 8th February 2021. Their parents completed OSA-18 and ESS-CHAD with the assistance of doctors. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and ROC curve of the serial tests were calculated, respectively. Results According to the ROC curve, the optimal cut-off value of nocturnal LSaO₂ for predicting OSA in children was 90.5% (P<0.001, AUC=0.82). The highest sensitivity of OSA-18 and ESS-CHAD for diagnosing OSA was 74.8% and 22.7%, respectively. The highest sensitivity of LSaO₂/OSA-18, LSaO₂/ESS-CHAD, OSA-18/ESS-CHAD in the diagnosis of OSA in children was 88.2 %, 68.1% and 77.3%, respectively. Conclusions The nocturnal LSaO₂ has clinical value in the diagnosis of OSA in children. OSA-18 has higher sensitivity but lower specificity than ESS-CHAD. The sensitivity and specificity of LSaO₂ combined with OSA-18 in diagnosing OSA are higher than the remaining serial tests, which could be used in primary screening OSA in children at grassroots hospitals where sleep monitoring is impossible.

Key words: sleep apnea, child, oxygen saturation, Epworth Sleepiness Scales