发作性睡病伴快速眼球运动期睡眠行为异常患者的临床特征及多导睡眠图改变  

Polysomnographic and clinical features in narcoleptic patients with rapid eye movement sleep behaviour disorder

作　　者：陈国艳[1] 邹慧莉[1] 杨婷[1] 宿长军[1] 

机构地区：[1]第四军医大学唐都医院神经内科,西安710038

出　　处：《中华神经科杂志》2012年第10期711-714,共4页Chinese Journal of Neurology

摘　　要：目的研究发作性睡病伴快速眼球运动（REM）期行为异常（RBD）患者一般特征、多导睡眠图（PSG）参数改变及REM期动作特征和分布特点。方法对比分析22例发作性睡病伴RBD、96例发作性睡病不伴RBD和21名健康对照一般特征、PSG参数及相关指标。分析22例发作性睡病伴RBD患者整夜连续视频PSG监测下的运动行为及分布特征。结果发作性睡病伴RBD组与发作性睡病不伴RBD组在PSG参数及相关指标的比较上差异无统计学意义。而发作性睡病伴或不伴RBD组（24．07±5．44、23．40±4．50）与健康对照组（20．15±4．52）比较体质量指数明显增加（F=4．869，P=0．009），PSG参数比较睡眠潜伏期（min）及REM睡眠潜伏期（min）缩短（4．41±7．01、3．55±3．98及14．69±9．62，x2=31．697，P=0．000；69．39±81．39、71．04±74．45及115．31±45．13，x2=11．485，P=0．003），1期睡眠百分比明显增加，慢波睡眠百分比减少，觉醒时间延长，大于5min觉醒次数增多。在发作性睡病伴RBD组中，RBD事件相当频繁地出现在整夜REM期睡眠的任意阶段。发声在睡眠的前后半程没有明显不同，而颜面部和肢体动作在睡眠的后半程增多。结论RBD在发作性睡病患者中发生率高，睡眠结构在发作性睡病伴或不伴RBD患者中无差异。RBD出现与病程长短无关。RBD在发作性睡病患者中主要以发声或颜面部及肢体动作为主，防御或攻击行为则较少见。Objective To describe clinical features, polysomnographic （PSG） alterations and characteristics of motor and distribution during rapid eye movement （REM） sleep in narcoleptic patients with REM sleep behavior disorder （RBD）. Methods We retrospectively summarized general features of 22 narcoleptic patients with RBD, 96 narcoleptic patients without RBD and 21 healthy subjects as controls. We compared their PSG and the related indexes in 3 groups. Then we analyzed a full-night video-PSG recording in a continuous series in 22 narcoleptic patients with RBD to identify their motor behavior and distribution features. Results There was no significant difference in PSG parameter and correlation index between the narcoleptic patients with RBD group and without RBD group. However, compared with normal control group （20. 15 ±4. 52） , narcoleptic patients with or without RBD（24. 07 ± 5.44,23.40 ± 4. 50）showed increased the body mass index （ F = 4. 869, P = 0. 009） , shortened NREM sleep and REM sleep （rain） latency at night （4.41 ± 7.01, 3.55± 3.98 and 14. 69 ± 9. 62, X2 = 31. 697, P = 0. 000 ; 69.39 ±81.39, 71.04 ±74. 45 and 115.31±45.13, X2 = 11.485, P = 0.003）, increased percentage of sleep stage 1, decreased percentage of slow wave sleep, delayed the arousal time and increased number of arousal episode longer than 5 minutes. In narcoleptic patients with RBD, RBD episodes occurred frequentlyatany stage of REM sleep through whole night and the frequency of vocalizations did not significantly differ between the two halves of the night. Pantomimes were significantly more frequent in RBD episodes of the second half of the night. Conclusions The prevalence of RBD is high in narcoleptic patients. Sleep architecture doesn＇ t differ between narcoleptic patients with and without RBD. There is no correlation between the occurrence of RBD and narcoleptic duration. In narcoleptic patients with RBD, vocalizations and pantomimes accounted formajor proportion of RBD episodes while aggressive-viol

关 键 词：发作性睡病 REM睡眠行为障碍 多道睡眠描记术 

分 类 号：R740[医药卫生—神经病学与精神病学]