脑干病变快速动眼期睡眠行为障碍  

Prevalence of REM sleep behavior disorder in patients with brainstem lesions

作　　者：陈健华[1] 黄颜[1] 刘秀琴[1] 孙鹤阳[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院神经内科,100730

出　　处：《中华医学杂志》2013年第37期2942-2945,共4页National Medical Journal of China

摘　　要：目的 研究脑干病变快速动眼期（REM）睡眠行为障碍（RBD）的患病率,以及RBD的发生与脑干病灶位置的关系.方法 2009年1月至2013年1月间收集在北京协和医院神经科诊治的脑干病变患者62例,同时期健康体检的对照组66例,进行快速眼动期睡眠行为筛查量表（RBDSQ）问卷调查,满足RBD诊断标准的进行多导睡眠图（PSG）及抑郁自评量表（SDS）、焦虑自评量表（SAS）测评.结果 脑干病变组平均年龄43 ±16（18 ～65）岁;对照组平均年龄41 ±13（18 ～65）岁.脑干病变组RBD 5例,占8.1％,均存在桥脑被盖部病灶;对照组RBD 2例,占3％.脑干组RBD患者SDS评分38 ±4（35 ～44）分,SAS评分43.0 ±5.8（36 ～49）分;对照组RBD患者SDS评分64±6（59 ～68）分,SAS评分69.5 ±2.1 （68 ～71）分.给予小剂量氯硝安定治疗,RBD症状消失.结论 脑干病变中RBD并不少见,确诊需结合临床及PSG检查.Objective To explore the prevalence of REM sleep behavior disorder （RBD） and define the brainstem structures likely to be involved in its pathogenesis in patients with brainstem lesions on magnetic resonance imaging （MRI）.Methods Sixty-two patients with definite brainstems lesions on brain MRI were recruited from Neurology Department,Peking Union Medical College Hospital.And 66 genderand-age-matched healthy subjects were included as controls.RBD screening questionnaire （RBDSQ） was provided.All patients fulfilling clinical criteria for RBD underwent a two-night polysomnography （PSG） with synchronized audio-visual recording and the evaluations of Zung self-rating depression scale （SDS） and Zung self-rating anxiety scale （SAS）.Results The brainstem group had a mean age of 43 ± 16 years （range,18-65） while the controls a mean age of 41 ± 13 years （range,18-65）.In brainstem group,SDS scores were 38 ± 4 （range,35-44） ; SAS scores 43.0 ± 5.8 （range,36-49）.In controls,SDS scores were 64 ±6 （range,59-68） ; SAS scores 69.5 ±2.1 （range,68-71）.Five patients in the brainstem group and two in the control group fulfilling the clinical criteria for RBD were confirmed after PSG.All five patients had focal lesion on pontine tegmentum.Treatment with clonazepam at bedtime completely resolved the RBD symptoms.Conclusion RBD is common in patients with brainstem lesions.And its definite diagnosis is based upon clinical symptoms and PSG examination.

关 键 词：脑干 快速动眼期睡眠行为障碍 患病率 

分 类 号：R741[医药卫生—神经病学与精神病学]