不同年龄阶段重度阻塞性睡眠呼吸暂停低通气综合征患者睡眠脑电波特征研究  

Age-based Analysis of Spectral Characteristics of Sleep EEG in Patients with Severe Obstructive Sleep Apneahypopnea Syndrome

作　　者：莫建明[1] 徐平[1] 唐安珏 李为[1] 宋卫东[1] MO Jianming;XU Ping;TANG Anjue;LI Wei;SONG Weidong(Department of Respiration,Peking University Shenzhen Hospital,Shenzhen 518000,China)

机构地区：[1]北京大学深圳医院呼吸与危重症医学科

出　　处：《中国全科医学》2019年第36期4447-4452,共6页Chinese General Practice

基　　金：2018年度深圳市卫生系统科研项目(SZBC2018019)

摘　　要：背景 阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种常见的睡眠障碍,既往研究表明,年长患者更容易出现睡眠结构的变化和认知功能下降,其原因尚未完全明确,且目前关于睡眠脑电波(EEG)和睡眠结构与不同年龄阶段OSAHS患者关系的研究较少.目的 探究不同年龄阶段重度OSAHS的EEG特征,旨在进一步为大脑可塑性变化提供重要信息,指导临床治疗.方法 选取2017年6月-2018年3月在北京大学深圳医院睡眠呼吸障碍疾病诊疗中心确诊的67例重度OSAHS患者,依据我国最新的年龄划分标准将其分为年轻组(18~40岁,n=34)和年长组(41~65岁,n=33).比较两组患者呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(LSpO2)、睡眠有效率,非快速眼动睡眠(NREM)各分期(N1、N2、N3期)、快速眼动睡眠(REM)期睡眠时间占总睡眠时间百分比,NREM期各波〔δ 波(0.5~4.0 Hz)、θ 波(4.1~8.0 Hz)、α 波(8.1~12.0 Hz)和 β 波(12.1~30.0 Hz)〕脑电能量密度;并分析两组患者NREM期各波脑电能量密度、REM期睡眠时间、睡眠有效率与AHI的相关性.结果 年长组患者N1期、N2期睡眠时间占总睡眠时间百分比大于年轻组,年长组患者N3期、REM期睡眠时间占总睡眠时间百分比小于年轻组(P<0.05).年长组患者N1期、N2期、N3期 δ 波脑电能量密度均低于年轻组(P<0.05).年长组患者N3期 θ 波脑电能量密度低于年轻组(P<0.05).年长组患者N2期、N3期 α 波脑电能量密度低于年轻组(P<0.05).年长组患者N1期、N2期、N3期 β 波脑电能量密度均高于年轻组(P<0.05).年轻组患者NREM期 δ 波、θ 波、α 波脑电能量密度及REM期睡眠时间、睡眠有效率与AHI呈负相关(r值分别为-0.338、-0.315、-0.383、-0.483、-0.501,P值均<0.05);年轻组患者NREM期 β 波脑电能量密度与AHI无直线相关关系(P>0.05).年长组患者NREM期各波脑电能量密度、REM期睡眠时间和睡眠有效率与AHI无直线相关关系(P>0.05).结论 �Background Obstructive sleep apnea-hypopnea syndrome(OSAHS)is one of the common sleep disorders.Previous studies demonstrate that change of sleep structure and decline of cognitive function are more likely to appear in older patients,with reasons incompletely determined yet.Up to now,there are few studies focusing on the relationship of the sleep electroencephalogram(EEG)and sleep structure with OSAHS patients at different ages.Objective To explore the characteristics of sleep EEG of patients with severe OSAHS by age,so as to further provide significant information about brain plasticity change for instructing clinical treatment.Methods In the study,67 patients definitely diagnosed with severe OSAHS from June 2017 to March 2018 in the Sleep Disordered Breathing Diagnosis and Therapy Center,Peking University Shenzhen Hospital were selected and were divided into the younger group(18-40 years old,n=34)and the older group(41-65 years old,n=33)based on the latest national age classification standard.We compared the two groups in the aspects of apneahypopnea index(AHI),the lowest SpO2(LSpO2)during the night,sleep efficiency,the percentage of sleep time during various non-rapid eye movement(NREM)sleep stages(N1,N2 and N3),and the percentage of rapid eye movement(REM)sleep period in the total sleep time,electroencephalograph power density of various waves〔EEG-δ(0.5-4.0 Hz),EEG-θ(4.1-8.0 Hz),EGG-α(8.1-12.0 Hz)and EGG-β(12.1-30.0 Hz)〕during NREM period,and analyzed the correlation of electroencephalograph power density during NREM,sleep time in REM period and sleep efficiency with AHI.Results As for the percentage of the sleep time during various stages in the total sleep time,it was higher during N1 and N2 stages in the older group than in the younger group,while was lower in N3 and REM period in the older group than in the younger group(P<0.05).During the stages of N1,N2 and N3,the power densities of EEG-δof patients in the older group were lower than those of patients in the younger group(P<0.05).The power dens

关 键 词：睡眠呼吸暂停综合征 脑电波 睡眠纺锤波 快速眼动睡眠 非快速眼动睡眠 

分 类 号：R563.8[医药卫生—呼吸系统]