颞叶癫痫患者的睡眠结构研究  

The macrostructure of sleep in patients with temporal lobe epilepsy

作　　者：郭崇伦[1,2] 张明[1] 邓丽影[1] 韩栋[1] 

机构地区：[1]南昌大学第二附属医院神经内科,330006 [2]江西省遂川县人民医院神经内科

出　　处：《实用医学杂志》2010年第8期1329-1331,共3页The Journal of Practical Medicine

基　　金：江西省科技厅计划资助项目(编号:E20030352)

摘　　要：目的:探讨颞叶癫痫(TLE)患者发作间期睡眠结构的特点及发作间期痫样放电(IEDs)对睡眠结构的影响。方法:TLE组26例,正常对照组20例;对两组分别进行Epworth思睡量表(ESS)、Zung氏抑郁自评量表(SDS)、Zung氏焦虑自评量表(SAS)评分,并进行全夜视频多导睡眠仪监测,并根据睡眠过程中是否记录到发作间期痫样放电将TLE患者再分为有IEDs组与无IEDs组分别进行统计,评价TLE组与正常对照组之间、发作间期痫样放电组与发作间期无痫样放电组之间的睡眠结构参数及ESS、SAS、SDS等各项评分的差异。结果:(1)TLE组与正常对照组相比NREM1期比例增加(P<0.05)、觉醒期比例增加(P<0.05)、REM潜伏期延长(P<0.05)、总睡眠时间减少(P<0.05)、睡眠效率下降(P<0.05)、觉醒次数增加(P<0.01)、入睡后觉醒时间增加(P<0.05);(2)在多导睡眠监测中有16例(61.5%)记录到了发作间期痫样放电、10例(38.5%)未记录到IEDs,有IEDs组与无IEDs组比较REM潜伏期延长(P<0.05)、睡眠效率下降(P<0.05);(3)TLE组的Epworth评分明显高于对照组(P<0.05),有IEDs组与无IEDs组Epworth评分无明显差异(P>0.05)。结论:TLE患者睡眠结构紊乱,睡眠进程受影响;IEDs可在TLE患者睡眠中出现,IEDs与睡眠有着密切的关系。Objective To explore the features of macrostructure of sleep in patietnts with temporal lobe epilepsy （TLE） during seizure-free periods and the effect of ineterictal epileptiform discharge （IED） on TLE. Methods 26 patients with TLE and 20 healthy control subjects were included in this study. All of the patitents and control subjects were assessed by Epworth sleepiness scale, Self-rating anxiety scale, and Self-rating depression scale, and monitored by polysomnography （PSG） for one night. The patients were then divided into two groups based on whether they developed IED during sleeping. Scores of ESS, SAS, and SDS and parameters of sleep macrostructure were compared not only between the patients and the subjects but all also between the patients who developed IED and those without IED. Results As compared with the control group, the percentage of NREM stage 1 and waking time increased in TLE group （P 〈 0.05 for both comparisons）, REM latency was prolonged （P 〈 0.05 ）, total sleep time was shorter （P 〈 0.05）, sleep efficiency was decreased （P 〈 0.05）, waking frequency increased （P 〈 0.01 ）, and waking time increased （P 〈 0.05）. During PSG monitoring, IED was recorded in 16 of 26 TLE patients （61.5%） ; the rest 10 （38.5%） did not occurred IED. In patients with IED, REM latency increased （P 〈 0.05） and sleep efficiency decreased （P 〈 0.05）. Epworth score was higher in TLE group than in the control group （P 〈 0.05） and did not differ significantly between patients with lED and those without IED （P 〉 0.05）. Conclusions Patients with temporal lobe epilepsy oceurrs turbulence in sleep macrostrueture and sleeping process is blocked. Ineterietal epileptiform discharge may develop in the patients during sleeping and is closely associated with sleeping.

关 键 词：癫痫 颞叶 发作间期痫样放电 睡眠结构 多导睡眠图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]