脑内谷氨酸和5-羟色胺增高是高原睡眠障碍的独立预测因素  

Elevated of the independent predictors of glutamate and hydroxytryptamine in encphalofluctuograph with sleep disorder at high altitude

作　　者：孔繁一[1] 刘诗翔[1] 张皓[1] 胡炜娜[1] 祝玲[1] 王昆[1] 刘枢晓[1] 

机构地区：[1]成都军区昆明总医院神经内科,650032

出　　处：《疑难病杂志》2013年第11期843-847,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：全军"十一五A类计划"(No.06MA141)

摘　　要：目的明确脑内神经递质变化对高原睡眠障碍的影响。方法对解放军驻迪庆高原海拔3800 m和驻昆明海拔1800 m的部队分别进行匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑(HAMA)和抑郁量表(HAMD)评定,采用脑涨落图分析仪无创性检测所有受试者脑内神经递质。采用析因分析明确睡眠质量和海拔高度的交互作用,采用多因素Logistic回归分析高原睡眠障碍的独立预测因素。结果共调查261人,最终纳入134人,均为男性。两地区被调查对象的年龄、文化程度、婚姻状况、HAMA、HAMD总分均无统计学差异(P>0.05)。高原组PSQI评分高于非高原组(7.02±2.40 vs 6.71±3.04,P=0.034.),睡眠障碍发生率为75.86%,(84/134),睡眠障碍者各项神经递质功率和兴奋抑制指数均低于睡眠正常者(P<0.05)。非高原地区,睡眠障碍者仅γ-氨基丁酸功率、谷氨酸功率和总功率低于睡眠正常者(P<0.05)。睡眠质量和海拔高度对各项神经递质实测功率均存在交互协同作用(P<0.05)。HAMD评分、谷氨酸和5-羟色胺功率增高是导致高原睡眠障碍的独立预测因素(P<0.05),γ-氨基丁酸和多巴胺功率增高则可能对高原睡眠质量有促进作用(P<0.05)。结论高原环境下,睡眠障碍者脑内各项神经递质功率均显著降低,这种变化与睡眠质量下降和海拔高度变化存在交互协同效应。脑内谷氨酸和5-羟色胺实测功率增高是导致高原睡眠障碍的独立预测因素,γ-氨基丁酸和多巴胺实测功率增高可能对高原睡眠质量有促进作用。Objective To determine the effects of neurotransmitters on sleep disorder at high altitude.Methods Soldiers stationed in Diqing plateau（3800m） and Kunming（1800m） were surveyed by Pittsburgh Sleep Quality Index（PSQI）,Hamilton Anxiety Scale（HAMA）,and Hamilton Depression Rating Scale（HAMD）.Neurotransmitters were detected by encphalofluctuograph（EFG）.Neurotransmitters of those with sleep disorder at high altitude（Diqing） and lowland（Kunming） were compared with those without sleep disorder.One Way ANOVA was employed to examine the relationship between sleep quality and altitude.Multiple logistic analyses was employed to determine the independent predictors of sleep disorder at high altitude.Results Two hundred and sixty one soldiers were surveyed and 134 were finally enrolled.There were no significant difference in age,education,marriage status,HAMA and HAMD（P 0.05）.Those stationed at high altitude had higher PSQI than those in lowland（7.02 ±2.40 vs.6.71 ±3.04,P =0.034）.The prevalence of sleep disorder at high altitude was 75.86%（84/134）,which was 2.36 folds higher than that in lowland.At high altitude,the power of all the neurotransmitters detected by EFG in subjects with sleep disorder and total power of neurotransmitters were significantly lower than those without sleep disorder（P 0.05）.In lowland,the power of gamma amino butyric acid,glutamate and total power of neurotransmittes were significantly lower than those without sleep disorder（P 0.05）.Sleep quality and altitude were correlated with each other（P 0.05）.HAMD,the power of glutamate and hydroxytryptamine independently predicts sleep disorder at high altitude,while gamma amino butyric acid and dopamine may helpful for improving sleep.Conclusion The power of neurotransmitters declined in subjects with sleep disorder at high altitude which was correlated with altitude.The elevated power of glutamateand hydroxytryptamine is independent predictors of sleep disorder at high altitude.

关 键 词：高原 睡眠障碍 神经递质 脑涨落图 

分 类 号：R740[医药卫生—神经病学与精神病学]