睡眠脑电成分对慢性意识障碍患者评估及预后预判的研究  

Study on sleep electroencephalogram composition for evaluation and prognosis prediction of patients with chronic disorders of consciousness

作　　者：夏晴 杨艺 强峻 曾春[2] 王勇[3] 夏小雨 党圆圆 路长宇 李凯 孔德生[2] 何江弘 赵元立[2] 刘献增 Xia Qing;Yang Yi;Qiang Jun;Zeng Chun;Wang Yong;Xia Xiaoyu;Dang Yuanyuan;Lu Changyu;Li Kai;Kong Desheng;He Jianghong;Zhao Yuanli;Liu Xianzeng(Department of Neurology,Peking University International Hospital,Beijing 102206,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Hebei Key Laboratory of Intelligent Rehabilitation and Neural Regulation,Yanshan University,Qinhuangdao 066004,China;Department of Neurology,The Seventh Medical Center,Chinese PLA General Hospital,Beijing 100700,China)

机构地区：[1]北京大学国际医院神经内科,北京102206 [2]首都医科大学附属北京天坛医院神经外科,北京100070 [3]燕山大学智能康复及神经调控河北重点实验室,秦皇岛066004 [4]解放军总医院第七医学中心神经外科,北京100700

出　　处：《中华神经创伤外科电子杂志》2020年第6期368-372,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的通过监测意识障碍(DOC)患者的脑电,分析患者治疗前后脑电背景活动及其特征性波形,比较不同意识水平以及不同预后患者在脑电成分上的差异,探寻DOC患者的脑电活动规律和睡眠期脑电活动的特征。方法收集自2020年1月至4月北京大学国际医院神经外科收治的6例DOC患者,采集患者治疗前后的修订版昏迷恢复量表评分,以及16 h以上的长程视频脑电图监测,分析DOC患者的脑电活动特征、睡眠脑电周期及成分。结果不同意识水平的患者均有可能出现枕区α节律,健侧为优势侧,睁眼时均未被抑制;但意识水平好的患者更有可能出现枕区α节律,预后较好的患者更有可能出现睡眠纺锤波。结论DOC患者是否出现枕区α节律以及是否出现特征性的睡眠脑电成分对意识水平及预后具有一定的提示意义,睡眠脑电活动的周期性有待进一步研究,对DOC患者的临床治疗节律调节及睡眠意识相关性理解有一定的参考意义。Objective To analyze the electroencephalogram(EEG)background activity and characteristic waveform of patients with disorders of consciousness(DOC)before and after treatment,compare the differences of EEG components in patients with different levels of consciousness and different prognosis,and explore the EEG activity patterns and characteristics of DOC patients in the sleeping period.Methods Six DOC patients admitted to the Neurosurgery Department of Peking University International Hospital from January to April 2020 were collected with coma recovery scale-revised score before and after treatment,and long-term video electroencephalogram monitoring was conducted more than 16 h,in which the characteristics of EEG activity,sleeping EEG cycle and composition of DOC patients were analyzed.Results Patients with different levels of consciousness were likely to have occipitalαrhythm.The healthy side was the dominant side,and was not inhibited when the eyes were opened.However,patients with good consciousness level were more likely to have occipitalαrhythm.Patients with better prognosis were more likely to have sleep spindles.Conclusion DOC patients whether with occipitalαrhythm or any characteristic of sleep EEG components have certain suggestive significance for the level of consciousness and prognosis,and the periodicity of sleep EEG needs to be investigated,which has certain reference significance for the clinical treatment rhythm regulation and sleep consciousness correlation understanding of DOC patients.

关 键 词：意识障碍 睡眠 脑电成分 植物状态 微意识状态 

分 类 号：R749.1[医药卫生—神经病学与精神病学]