慢性失眠患者动态脑血流自动调节功能的研究  

Compromised cerebral autoregulation function in patients with chronic insomnia disorder

作　　者：吕珊[1] 郭珍妮[1] 孙晴晴[1] 朱建楠[1] 张然[1] 王赞[1] 

机构地区：[1]吉林大学第一医院神经内科,长春130021

出　　处：《中华神经科杂志》2017年第8期585-589,共5页Chinese Journal of Neurology

基　　金：国家自然科学基金资助项目（81501166）;吉林省科技厅科技发展计划重点科技攻关项目（20140204038YY）

摘　　要：目的 探讨慢性失眠患者的动态脑血流自动调节功能.方法 收集2016年1-12月就诊于吉林大学第一医院神经内科门诊的慢性失眠患者60例,其中伴广泛焦虑者54例,同时收集40名性别、年龄与其相匹配的健康志愿者.对每位受试者进行医院焦虑抑郁量表（Hospital Anxiety and Depression scale,HAD）评分及夜间睡眠监测.采用经颅多普勒超声监测受试者的双侧大脑中动脉血流速度,同时使用无创血压监测仪实时同步监测受试者的手指血压.将获得的数据通过传递函数进行分析,得出动态脑血流自动调节参数（相位差及相关函数）,比较慢性失眠患者与健康对照组之间动态脑血流自动调节参数的差异.结果 伴广泛焦虑的慢性失眠患者的相位差明显低于健康对照组[（46.89±15.39）°]与[（56.00±12.05）°],提示其动态脑血流自动调节功能受损（t=3.439,P=0.001）.受试者的相位差与HAD量表评分高低并无相关关系.结论 伴有广泛焦虑的慢性失眠患者的动态脑血流自动调节功能受损,但其受损程度与焦虑、抑郁的程度并无线性相关.Objective To analyze the cerebral autoregulation capability in patients with chronic insomnia disorder （CID）.Methods Sixty CID patients （54 with generalized anxiety disorder） and 40 healthy controls were enrolled in this study.Polysomnography was done in all the participants.Noninvasive continuous cerebral blood flow velocity of bilateral middle artery and arterial blood pressure were recorded simultaneously using transcranial Doppler and a servo-controlled plethysmograph.Transfer function analysis was used to derive the autoregulatory parameters, including phase difference and coherence function.Results The phase difference values of CID patients with generalized anxiety disorder were significantly lower than that of the healthy controls （（46.89±15.39）°vs （56.00±12.05）°, t=3.439, P=0.001）.In the correlation analysis, we further found that there was no correlation among phase difference values and the score of Hospital Anxiety and Depression scale.Conclusions The dynamic cerebral autoregulation was compromised in CID patients with generalized anxiety disorder regardless of the degrees of anxiety and depression.Dynamic cerebral autoregulation may be a potential therapeutic target in improving neurological symptoms in patients with CID.

关 键 词：入睡和睡眠障碍 焦虑 血流速度 超声检查 多普勒 经颅 

分 类 号：R740[医药卫生—神经病学与精神病学]