右美托咪定对顽固性原发性失眠患者的脑电超慢涨落图的影响  

Effect of Dexmedetomidine on Encephalofluetuograph for refractory primary insomnia patients

作　　者：郎莹[1] 蒋晓江[1] 张远凤[1] 陈尼卡[1] 李训军[1] 钟代曲[1] 刘雅贞[1] 

机构地区：[1]中国人民解放军第三军医大学附属大坪医院神经内科三病区,400042

出　　处：《神经疾病与精神卫生》2013年第6期573-577,共5页Journal of Neuroscience and Mental Health

摘　　要：目的 观察右美托咪定睡眠诱导平衡治疗后顽固性原发性失眠患者脑内神经递质活动的变化.方法 对23例顽固性原发性失眠且内科治疗效果不佳的患者实施右美托咪定睡眠诱导平衡治疗,每日1h,持续3d,对照组23例患者采用常规方案治疗.采用阿森斯失眠量表及过度觉醒量袁评估患者治疗前后的主观症状变化,并采用脑电超慢涨落技术对治疗前后的脑内神经递质分别进行检测.结果 治疗后治疗组阿森斯失眠量表及过度觉醒量表指标分值明显改善,治疗前患者脑内5-羟色胺活动水平偏低,去甲肾上腺素活动水平偏高,经睡眠诱导平衡治疗后5-羟色胺活动水平升高,去甲肾上腺素活动水平降低,差异具有统计学意义（P＜0.05）,余神经递质活动水平无明显变化,差异无统计学意义（P＞0.05）,且无严重治疗不良反应.结论 顽固性原发性失眠患者脑内神经递质存在5-羟色胺活动水平偏低,去甲肾上腺素活动水平偏高,右美托咪定睡眠诱导平衡术治疗可以调节它们的活动水平,同时患者的失眠症状及过度觉醒表现也有所改善.Objective To study the therapeutic effect of dexmedetomidine on neurotransmitters in the brain for refractory primary insomnia patients. Methods 23 refractory primary insomnia patients with poor effect were given dexmedetomidine--induced sleep balance treatment, for 3 days, 1 hours each time, while 23 patients in the control group were given the conventional treatment. Athens Insomnia Scale（AIS）and The Hyperarousal Scale were also detected and compared between the pre--treatment and post--treatment of two groups to evaluate of subjective symptoms. At the same time, using Encepha- lofluetuograph Technology to detect the neurotransmitters in the brain before and after the treatment respectively. Results The scores of AIS and HAS in treatment group were improved than those before the treatment （P 〈 0.05）. The 5--HT level of treatment group was advanced than that before the treatment （P 〈 0.05）, and the NE level of treatment group was decreased than that before the treatment （P 〈0.05）, other neurotransmitters with no change. While the react score of AIS and HAS in the control group after the treatment had no statistical significance compared with those before the treatment （P ：〉 0.05）. At the same time, the 5--HT and NE level hadn＇t been changed significantly than that before the treatment （P 〉 0.05）. Conclusions The 5-- HT level of refractory primary insomnia patients is low the NE level is on the high side. Dexmedetomidine＇induced sleep balance treatment can adjust the neu- rotransmitter activity levels, improve insomnia symptoms and hyperarousal manifestation.

关 键 词：失眠 右美托咪定 脑电超慢涨落图 神经递质 去甲肾上腺素 5-羟色胺 

分 类 号：R749.71[医药卫生—神经病学与精神病学]