阻塞性睡眠呼吸障碍与神经衰弱  

Obstructive sleep-related breathing disorders and neurasthenia.

作　　者：游国雄[1] 竺士秀[1] 张可经[1] 杨婷[1] 

机构地区：[1]第四军医大学唐都医院神经内科

出　　处：《中国神经精神疾病杂志》1998年第4期224-227,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨由于阻塞性睡眠呼吸障碍（０－ＳＲＢＤ）引起的神经衰弱状态的临床特点、原因、发病机制和治疗方法。方法根据７４例临床表现为神经衰弱患者的多导睡眠图所见，结合临床症状进行分析。结果５７例（７７０％）有不同程度的Ｏ－ＳＲＢＤ，已可确诊为阻塞性睡眠呼吸暂停综合征的１９例（２５７％）。肥胖、响鼾、白日思睡和晨起即有症状，为本病神经衰弱状态的主要特点。睡眠低氧血症及其继发的病理生理改变引起的脑缺氧为发病的主要机制。根治Ｏ－ＳＲＢＤ的病因即各种原因所致的上气道狭窄，以改善睡眠低氧血症，为治疗的关键。Objective To investigate the clinical manifestation, cause, mechanism and treatment of the neurasthenia state caused by obstructive sleeprelated breathing disorders (OSRBD). Methods To analyze polysomnographic data and the clinical findings of 74 patients suffered from neurasthenia symptoms. Results Totally, 57 cases (77%) showed O-SRBD of various degrees, among them 19 cases (25.7%) were diagnosed definitely as obstructive sleep apnea syndrome. The clinical manifestations were characterized by obesity, loud snoring, excessive daytime sleep and the neurasthenia symptoms occurred shortly after morning awakening. Cerebral anoxia due to nocturnal hypoxemia and its consequential pathological changes were the main mechanisms of this desease. Partial obstruction of the upper respiratory airway was the cause of O-SRBD. Radical treatment of the causes of O-SRBD such as uvulo-palato-pharyngeal plasty (UPPP) in the cases of narrowed oropharynx or weight reduction in obese patients was suggested. Otherwise, administration of drugs such as chloroimipramine or nocturnal application of nasal continuous positive airway pressure (nCPAP) devices was considered. Conclusions Overlook either neurasthenia state caused by O-SRBD or neurasthenia aggravated by O-SRBD should be avoided. 

关 键 词：神经衰弱 多导睡眠图 阻塞性 睡眠呼吸障碍 SRBD 

分 类 号：R563.8[医药卫生—呼吸系统] R749.71[医药卫生—内科学]