Objective: To explore the feasibility of applying telemedicine model in disease management for patients with obstructive sleep apnea hypopnea syndrome (OSAHS) in China. Methods: A total of 24 patients were enrolled with suspected OSAHS who were admitted to the Sleep Center of Peking University People's Hospital from October 2015 to September 2016. Patients were diagnosed by electronic questionnaire assessment and home sleep apnea monitoring (HSAT) and were treated with remote automatic positive airway pressure (APAP). After 1 week, 1 month and 3 months of treatment, the patients were followed up by video. The follow-up questionnaire was completed by the patients through an independent data management platform. The APAP treatment data and compliance data were obtained through a built-in digital card of the APAP device. Linear regression model was used to explore the factors related to patient compliance. One-way repeated-measure analysis of variance was used to compare the changes of APAP duration and apnea hypopnea index (AHI) among patients at different treatment time points. Paired t-test was used to compare the EPWORTH scale (ESS) scores before and after treatment. Results: A total of 22 patients were diagnosed with OSAHS, including 20 males (90.9%), aged (45.6±10.2) years and AHI before treatment was (46.9±20.4) times/h. A total of 20 OSAHS patients received APAP treatment, and the proportion of patients with good compliance after 1 week, 1 month and 3 months of treatment were 15/19, 10/19 and 8/18, respectively. The severity of sleepiness before treatment affected compliance. Each 1-point increase in ESS score was associated with a 6.16% (95%CI: 3.01%, 9.31%) increase in compliance. Age, body mass index and AHI before treatment had no effect on compliance (all P values>0.05). The AHI of the patients who had been treated for 1 week, 1 month and 3 months were (2.5±2.1), (2.2±1.6) and (1.9±1.0) times/h, respectively. (P=0.195). After 3 months of treatment, the ESS score was (7.0±3.3), lower than that before treatment (10.6±3.1) (P=0.079). Conclusion: Telemedicine mode of diagnosis and treatment of OSAHS patients has good therapeutic effect and patient compliance, which is practical and feasible.
目的： 探讨在中国将远程医疗模式应用于阻塞性睡眠呼吸暂停低通气综合征（OSAHS）诊治的可行性。 方法： 纳入2015年10月至2016年9月就诊于北京大学人民医院睡眠中心的24例疑似OSAHS患者，以电子问卷评估和家庭睡眠呼吸暂停监测（HSAT）进行确诊，对确诊患者进行远程自动气道正压通气（APAP）治疗。治疗满1周、1个月和3个月时分别对患者进行视频随访，通过独立建立的数据管理平台由患者填写随访问卷，通过APAP内置的数码卡获取APAP治疗数据和依从性数据。采用线性回归模型探索影响患者依从性的相关因素，采用单因素重复测量方差分析比较不同治疗时点患者APAP使用时间和呼吸暂停低通气指数（AHI）等指标的变化，采用配对t检验比较治疗前后爱泼沃斯嗜睡量表（ESS）评分。 结果： 确诊为OSAHS的患者共22例，其中男性20例（90.9%），年龄为（45.6±10.2）岁，治疗前患者AHI为（46.9±20.4）次/h。20例OSAHS患者接受了APAP治疗，治疗满1周、1个月和3个月时依从性良好患者占比分别为15/19、10/19和8/18。患者治疗前嗜睡严重程度影响依从性，ESS评分每增加1分，依从性（95%CI）增加6.16%（3.01%，9.31%），年龄、体质指数及治疗前AHI对依从性影响均无统计学意义（均P>0.05）。治疗满1周、1个月和3个月患者AHI分别为（2.5±2.1）、（2.2±1.6）和（1.9±1.0）次/h（P=0.195）；治疗满3个月患者ESS评分为（7.0±3.3）分，低于治疗前（10.6±3.1）分（P=0.079）。 结论： 远程医疗模式诊治OSAHS的患者依从性和治疗效果好，实际可行。.