右美托咪定诱导睡眠治疗顽固性失眠的疗效  

Efficacy of dexmedetomidine in the treatment of refractory insomnia

作　　者：倪春平 杨静 王兴[1] 程善飞[1] 祁涛 NI Chunping;YANG Jing;WANG Xing(Department of Anesthesiology,Huzhou Third People's Hospitals Huzhou 3U100,CHINA)

机构地区：[1]湖州市第三人民医院麻醉科,浙江313100 [2]南京医科大学第一附属医院麻醉与围术期医学科

出　　处：《江苏医药》2020年第8期829-831,共3页Jiangsu Medical Journal

基　　金：湖州市科学技术局项目(2019GYB60)。

摘　　要：目的观察右美托咪定诱导睡眠治疗顽固性失眠的临床效果。方法60例顽固性失眠患者随机分为观察组和对照组,每组30例。对照组患者按《中国成人失眠诊断与治疗指南》给予治疗;观察组加用右美托咪定诱导睡眠。其方法是每晚22∶00静脉泵注右美托咪定0.6μg·kg-1·h^-1,10 min后调整速率为0.25μg·kg-1·h^-1维持50 min,共治疗7 d。记录两组治疗前和治疗结束时的匹兹堡睡眠质量指数(PSQI)评分和汉密尔顿焦虑量表(HAMA)评分。同时检测两组治疗前和治疗结束时的血清皮质醇水平,记录不良反应。结果治疗后,观察组PSQI总分低于对照组[(11.9±3.1)分vs.(15.1±2.9)分](P<0.05)。观察组和对照组治疗结束时的HAMA评分均低于治疗前[(8.9±1.4)分vs.(12.5±2.5)分]和[(10.3±2.1)分vs.(12.1±2.2)分](P<0.05),且治疗结束时观察组低于对照组(P<0.05)。观察组治疗结束时的血清皮质醇水平低于对照组[(263.6±99.4)nmol/L vs.(320.7±92.1)nmol/L](P<0.05)。两组患者在治疗期间均未发生呼吸和心血管系统等不良反应。结论在传统治疗的基础上,加用右美托咪定诱导睡眠更能安全、有效治疗顽固性失眠。Objective To observe the clinical efficacy of dexmedetomidine in the treatment of refractory insomnia.Methods Sixty patients with refractory insomnia were randomly divided into two groups with 30 cases each.The patients in group B were treated according to the guideline for the diagnosis and treatment of insomnia in Chinese adults.The patients in group A were treated additionally with dextromethoridine inducing sleep for seven days,which was performed every 10∶00 pm.by intravenous infusion of dexmedetomidine 0.6μg·kg-1·h^-1 in 10 minutes and then followed by an infusion of dexmedetomidine 0.25μg·kg-1·h^-1for 50 minutes.The Pittsburgh Sleep Qualify Index(PSQI)score and Hamilton Anxiety Scale(HAMA)score were recorded before treatment(D0)and at the end of treatment(D7).Serum cortisol was detected at D0 and D7.The adverse responses were observed as well.Results Total PSQI score at D7 was lower in group A than that in group B[(11.9±3.1)points vs.(15.1±2.9)points](P<0.05).HAMA score in groups of A and B was lower at D7 than that at D0[(8.9±1.4)points vs.(12.5±2.5)points and(10.3±2.1)points vs.(12.1±2.2)points](P<0.05),which at D7 was lower in group A than that in group B(P<0.05).Serum cortisol level at D7 was lower in group A than that in group B[(263.6±99.4)nmol/L vs.(320.7±92.1)nmol/L](P<0.05).There were no adverse responses,such as respiratory and cardiovascular system,in both groups during treatment.Conclusion On the basis of the conventional treatments,additionally use of dexmedetomidine inducing sleep can be more effective in the treatment of refractory insomnia.

关 键 词：右美托咪定 顽固性失眠 皮质醇 

分 类 号：R614[医药卫生—麻醉学]