可用作失眠症诊断的多导睡眠图指标探讨  

Indexes of polysomnography for diagnosis of insomnia

作　　者：罗现科 田文杨 周璐[2] 王雨晴[2] 赵倩煜 张昕洋 张新宁 陈志刚[1] LUO Xianke;TIAN Wenyang;ZHOU Lu;WANG Yuqing;ZHAO Qianyu;ZHANG Xinyang;ZHANG Xinning;CHEN Zhigang(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;不详)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学

出　　处：《山东医药》2020年第9期14-17,共4页Shandong Medical Journal

基　　金：首都卫生发展科研专项基金资助课题(2018-2-4202)。

摘　　要：目的探讨可用作失眠症诊断的多导睡眠图(PSG)指标。方法失眠症患者(失眠组)28例、健康志愿者(正常对照组)33例均在独立监测室内接受PSG监测,失眠组进行连续两晚的PSG监测,分别记为失眠组首夜、失眠组次夜,正常对照组仅监测一晚。观察并记录两组受试者的睡眠进程指标[卧床时间(TIB)、睡眠总时间(TST)、睡眠潜伏期(SL)、睡眠效率(SE)、醒觉次数、觉醒总时间]、睡眠结构指标[N1、N2、N3期及快速动眼期(REM)持续时间占TST的百分比,分别记为N1%、N2%、N3%、REM%]、N2和N3期特征波指标(N2期纺锤波数量、N2期纺锤波密度、N3期δ波数量、N3期δ波密度),观察失眠组首夜、正常对照组监测当晚失眠情况。结果和正常对照组相比,失眠组首夜醒觉次数、觉醒总时间、N3期δ波数量、N3期δ波密度均增多(P均<0.05);与失眠组次夜相比,失眠组首夜N2%升高(P<0.05),其余指标均无显著性差异(P均>0.05)。失眠组首夜SL>30 min者16例,醒觉次数≥2次者27例,TST<6.5 h者19例;正常对照组SL>30 min者25例,醒觉次数≥2次者30例,TST<6.5 h者19例。结论在睡眠环境和睡眠舒适度改变的情况下,PSG监测中醒觉次数、觉醒总时间、N3期δ波数量及N3期δ波密度可作为诊断失眠症的指标。Objective To explore the indexes of polysomnography(PSG)which can be used in the diagnosis of insomnia.Methods Twenty-eight insomnia patients(insomnia group)and 33 healthy volunteers(normal control group)received PSG monitoring in the independent monitoring room.The patients in the insomnia group received PSG monitoring for two consecutive nights,which were separately recorded as the first insomnia night and the second insomnia night in the insomnia group.In the normal control group,we only monitored them one night.We observed and recorded the sleep progress index[total time in bed(TIB),total sleep time(TST),sleep latency(SL),sleep efficiency(SE),times,and total time of wakefulness]and sleep structure indexes[the percentages of duration of N1,N2,N3 and rapid eye movement(REM)stages in TST,which were recorded as N1%,N2%,N3%,and REM%],characteristic wave indexes in the N2 and N3 stages,and observed the insomnia on the first insomnia night of the insomnia group and on the monitoring night in the control group.Results Compared with the normal control group,the number and total time of wakefulness,the number ofδwaves in N3 phase,and the density ofδwaves in N3 phase of first insomnia night in the insomnia group increased(all P<0.05);compared with the second insomnia night in the insomnia group,the N2%on the first insomnia night in the insomnia group increased(P<0.05),and the other indexes had no significant differences(all P>0.05).In the insomnia group,there were 16 cases with SL>30 min,27 cases with wakefulness times≥2,and 19 cases with TST<6.5 h.In the normal control group,there were 25 cases with SL>30 min,30 cases with wakefulness times≥2,and 19 cases with TST<6.5 h.Conclusion With the changes in sleeping environment and sleeping comfort,the number and total time of wakefulness,the number ofδwaves in the N3 phase and the density ofδwaves in the N3 phase in PSG monitoring can be used as the indicators for the diagnosis of insomnia.

关 键 词：多导睡眠图 失眠症 觉醒次数 觉醒总时间 N3期δ波数量 N3期δ波密度 

分 类 号：R741.044[医药卫生—神经病学与精神病学]