儿童发作性睡病临床及电生理学特征  

Clinical spectrum and electrophysiology in childhood narcolepsy

作　　者：吕凌云[1] 王立文[1] 崔雯[1] 朱彦丽[1] 

机构地区：[1]首都儿科研究所附属儿童医院,100020

出　　处：《北京医学》2009年第7期404-406,共3页Beijing Medical Journal

摘　　要：目的观察儿童发作性睡病的临床特征,了解患儿夜间睡眠结构的变化,探讨多次睡眠潜伏期试验(MSLT)在诊断发作性睡病中的价值。方法对26例发作性睡病患儿的临床资料进行分析,采用多导睡眠生理监测仪对患儿行MSLT检查,对其中18例及30例正常儿童进行整夜多导睡眠图描记(PSG)。结果①26例患儿(100%)均以睡眠过多为首发症状,9例(35%)有猝倒发作,4例(15%)有入睡前幻觉,仅2例(7%)有睡眠瘫痪。②MSLT结果:平均睡眠潜伏期均缩短,26例均<5min,18例(69%)出现2次或更多的睡眠始发REM睡眠(SOREPs)。③PSG结果:患儿睡眠潜伏期及REM潜伏期均缩短;睡眠效率降低;NREMⅠ期睡眠时间增加,Ⅲ+Ⅳ睡眠时间减少;觉醒次数增多。结论儿童发作性睡病主要以白天不可抗拒的睡眠为主,睡眠瘫痪、入睡幻觉等主观叙述较成人少。MSLT对发作性睡病的诊断具有重要参考价值。发作性睡病患儿存在睡眠结构异常。Objective To observe the clinical spectrum and changes in nocturnal sleeping pattern ,to explore the diagnostic value of multiple sleep latency test （MSLT） in childhood narcolepsy. Methods To analyze clinical data gathering from 26 cases of suspected childhood narcolepsy. Simultaneously, MSLT was recorded, in which 18 cases and 30 normal controls completed whole night polysomnogram （PSG）. Results （1）The first symptom to appear is excessive sleepiness in all 26（ 100% ）, There are 9 cases （35%） with cataplexy, 4 cases（ 15% ） with hypnagogic hallucination, 2 cases（7% ） with sleep paralysis.（2）All of them have shortened average sleep latency （less than 5 rain）. There are 18 cases （69%） with twice or more sleep - onset rapid eye movement period （SOREMPs）. （3） PSG： the sleep latency and REM （ rapid eye movement） sleep latency were shortened, sleep efficiency were depressed, proportion of stage Ⅰ were increased, proportion of stage Ⅲ＋ Ⅳ were decreased, and frequency of waking up were increased. Conclusions Childhood narcolepsy appears predominantly as daytime irresistible sleep. Comparing with adult counterparts, less sleep paralysis and hypnagogic hallucination appeared. MSLT is important reference to diagnoses narcolepsy. There are changes in nocturnal sleeping pattern in narcolepsy children.

关 键 词：发作性睡病 整夜多导睡眠图 多次睡眠潜伏期试验 

分 类 号：R748[医药卫生—神经病学与精神病学]