学龄期局灶性发作癫患儿睡眠结构的变化  

Changes of Sleep Architecture in School-Age Children with Idiopathic Partial Epilepsy

作　　者：许杰[1] 刘智胜[2] 孙丹[2] 张苏明[1] 江军[2] 吴革菲[2] 胡家胜[2] 王芳琳[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030 [2]武汉市儿童医院神经内科,武汉430016

出　　处：《实用儿科临床杂志》2010年第6期433-436,共4页Journal of Applied Clinical Pediatrics

基　　金：湖北省卫生厅青年科技人才基金项目(QJX2005-22);武汉市科技局社会发展科技攻关计划项目(200860923433)

摘　　要：目的研究学龄期局灶性癫患儿发作间期睡眠结构的变化。方法应用Solar2000N神经中央监护系统对23例6～12岁局灶性癫患儿(男15例,女8例)及15例年龄、性别与之相匹配的健康儿童(健康对照组,男11例,女4例)进行全夜自然睡眠多导监测,并将23例局灶性癫患儿按照样放电出现部位(额叶癫组、颞叶癫组、枕叶癫组),发作好发时间(睡眠发作组、清醒发作组、睡眠+清醒发作组)及服用抗癫药物类型(卡马西平治疗组,卡马西平+托吡酯治疗组)进行分组,应用SPSS13.0软件分析各组患儿与健康儿童之间各项睡眠参数的差异。结果与健康对照组比较,学龄期局灶性癫患儿非快速眼动(NREM)睡眠1期比例延长(P<0.05),慢波睡眠(SWS)比例显著减少(P<0.01);额叶癫组各项睡眠参数与健康对照组比较差异无统计学意义,颞叶癫组患儿NREM睡眠1期比例及觉醒时间延长(Pa<0.05),枕叶癫组SWS比例与健康对照组比较差异有统计学意义(P<0.05);睡眠发作组觉醒次数增加(P<0.05),NREM睡眠1期比例增加(P<0.05),清醒发作组SWS比例减少(P<0.05);卡马西平+托吡酯组与未服药组比较,快速眼动(REM)睡眠时间增加(P<0.05)。结论学龄期局灶性癫患儿浅睡眠增多,深睡眠减少,以NREM1期睡眠增多为主;颞叶癫显示了更多的觉醒时间;易在睡眠中发作的癫患儿觉醒次数增加;卡马西平+托吡酯治疗可增加局灶性癫患儿的REM睡眠时间。Objective To investigate the changes of sleep architecture in school-age children with idiopathic partial epilepsy.Methods Twenty-three children with partial epilepsy（aged 6-12 years old;15 boys,8 girls）and 15 healthy children（11 boys,4 girls）who had same age and gender to the patients with partial epilepsy（healthy control group）were investigated with a national polysomnography system.The 23 children with partial epilepsy were divided into frontal lobe epilepsy group,temporal lobe epilepsy group and occipital lobe epilepsy group according to the location of epileptic discharge;according to the attack time of seizure,they were divided into sleeping seizure group,waking seizure group and full-attack group;according to the condition of antiepileptic drugs consuming,they were divided into carbamazepine（CBZ）group and CBZ＋topiramate（TPM）group.They were monitored for a whole night.Most of sleep parameters were analyzed by SPSS 13.0 software between every groups.Results Compared with the healthy control group,the percentage of stage 1 in non-rapid eye movement（NREM）sleep prolonged（P〈0.05）,while the percentage of slow wave sleep（SWS）decreased in partial epilepsy group（P〈0.01）.For the patients with frontal lobe epilepsy,there was no significant difference compared with healthy control group,while the patients with temporal lobe epilepsy had more awaking time compared with healthy control group（P〈0.05）.And the patients with epilepsy in sleep could awake more times than that of healthy control group（P〈0.05）,and the percentage of stage 1 in NREM sleep also prolonged（P〈0.05）,while the patients with waking seizure had less time in SWS compared with healthy control group（P〈0.05）.The partial epileptics treated with CBZ＋TPM had more time of rapid eye movement（REM）sleep than that of the untreated patients（P〈0.05）.Conclusions Children with partial epilepsy had a broken sleep architecture,including more light sleep and lower deep sleep.Moreover,different ki

关 键 词：局灶性癫 睡眠结构 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]