双相障碍I型患者缓解期昼夜静息-活动节律与睡眠模式的体动记录研究  

Circadian rhythm of rest-activity and sleep pattern in remitted patients with bipolar I disorder: An actigraphy study

作　　者：李瑽睿 刘亚平[2] 潘集阳[1] 

机构地区：[1]暨南大学附属第一医院精神医学科,广州510632 [2]香港中文大学精神科学系

出　　处：《中国心理卫生杂志》2016年第3期161-166,共6页Chinese Mental Health Journal

摘　　要：目的:探讨双相障碍I型患者缓解期昼夜静息-活动节律和睡眠模式的特点。方法:纳入符合精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的20例双相障碍I型缓解期患者和20例年龄、性别匹配的正常对照者,分别连续佩戴7天的Actigraph体动记录仪,比较两组间的主观睡眠情况(使用匹兹堡睡眠质量指数量表)和客观睡眠参数、活动量的平均值以及昼夜静息-活动节律参数指标(Actigraph监测记录)。结果:双相障碍I型患者缓解期组昼夜静息-活动节律变异性高于正常对照组[(0.8±0.1)vs.(0.7±0.1),P<0.01],而两组的日间稳定性差异无统计学意义(P>0.05);经体质量加权后,双相障碍I型患者缓解期组的活动量明显低于正常对照组[(13.9±5.0)k J/kg vs.(17.8±3.2)k J/kg,P<0.01];双相障碍I型患者缓解期组在静坐级活动所耗时间比正常对照组长[(18.2±2.0)h vs.(16.8±1.2)h,P<0.05],在轻度至活跃级活动所耗时间比正常对照组短[0.8(0.1,7.8)h vs.2.0(1.0,7.6)h,P<0.001],而在生活方式级活动时间差异无统计学意义;双相障碍I型患者缓解期组与正常对照组的客观睡眠参数差异无统计学意义。结论:双相障碍I型患者即使在缓解期仍具有明显的昼夜静息-活动节律的紊乱,特别是昼夜节律性改变。Objective： To explore the characteristics of circadian rhythms of rest-activity and sleep pattern in remitted patients w ith bipolar I disorder. Methods： Tw enty patients w ith bipolar I disorder（ BD） diagnosed according to the Diagnostic and Statistical M anual of M ental Disorders（ DSM-IV） criteria and tw enty healthy controls matched for age and gender w ere recruited. All subjects w ere compared on subjective sleep measures（ Pittsburgh Sleep Questionnaire Inventory; PQSI） and objective measures（ mean scores of activity and sleep,circadian activity variability in actigraphy） as recorded by 7 consecutive days. Results： Compared w ith normal controls,intra-daily variability w as higher in patients w ith BD [（ 0. 8 ± 0. 1） vs.（ 0. 7 ± 0. 1）,P 〈0. 01],but the difference of interdaily stability betw een the tw o groups w as not significant（ P〉 0. 05）. After w eighted by body w eight,energy expenditure w as significantly low er in BD group than in normal controls [（ 13. 9 ± 5. 0） k J / kg vs.（ 17. 8 ± 2. 0）k J / kg,P 0. 01]. The time spent on activity of sedentary level w as longer and the time spent on activity of light tomoderate level w as shorter in BD group than in normal controls [（ 18. 2 ± 2. 0） h vs.（ 16. 8 ± 1. 2） h,P 0. 05;0. 8（ 0. 1,7. 8） h vs. 2. 0（ 1. 0,7. 6） h,P 0. 001]. While the time spent on activity of lifestyle level w as not significantly different. No difference of actigraphy-measured sleep parameters w as found betw een the tw o groups. Conclusion： Circadian activity disruption is apparent in bipolar patients even during remission,especially intra-daily variability.

关 键 词：双相障碍I型 缓解期 昼夜静息-活动节律 睡眠 体动记录仪 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R338.63[医药卫生—临床医学]