不安腿综合征与皮肤交感及R-R间期变化率的相关性  

Study on restless legs syndrome and its relationship with sympathetic skin response(SSR)and R-R interval variability(RRIV)

作　　者：詹银萍 汪超男 王甜甜 张力三[1] 蒋红[1] ZHAN Yinping;WANG Chaonan;WANG Tiantian;ZHANG Lisan;JIANG Hong(Department of Neurology,Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine,Zhejiang Youth Hospital,Hangzhou 310020,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院神经内科,杭州310020 [2]浙江省青春医院

出　　处：《中国神经精神疾病杂志》2021年第4期193-196,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：浙江省2020年自然科学基金(编号:2020KY164)。

摘　　要：目的研究不安腿综合征(restless legs syndrome,RLS)皮肤交感反应(sympathetic skin response,SSR)与R-R间期变化率(R-R interval variability,RRIV)的相关性,旨在通过神经电生理评估RLS的自主神经功能。方法排除焦虑状态、抑郁状态等其他干扰因素后,将37例原发性RLS患者与30名对照者比较。两组均进行SSR及RRIV检查,将SSR的起始潜伏期、波幅和平静呼吸、深呼吸状态时的RRIV结果统计并分析。结果RLS组患者的上下肢平均潜伏期分别为(1.475±0.108)ms和(2.027±0.216)ms,上下肢平均波幅分别为(2.319±1.836)mV和(1.156±0.789)mV;对照组的上下肢平均潜伏期分别为(1.429±0.051)ms和(2.037±0.143)ms,上下肢平均波幅分别为(1.929±0.684)mV和(0.804±0.422)mV。RLS组和对照组之间的SSR的潜伏期平均值、波幅平均值指标均没有统计学差异(P>0.05)。但RLS患者组中SSR异常率指标与对照组有差异:表现为SSR波幅增高和(或)潜伏期缩短的共计10例(27.03%);表现为SSR波幅降低,潜伏期延长和(或)波形缺失的共计12例(32.43%),其中波形缺失3例(8.11%)。此外,RLS组与对照组RRIV的R%和D%均值比较有统计学差异(均P<0.01)。RRIV异常主要表现为R%及D%降低:R%降低占26/37(70.27%);D%降低占33/37(89.19%)。结论SSR指标的改变可能与RLS患者的情绪异常有关。RRIV中的R%和D%降低,是RLS较典型的表现,不易受情绪干扰。Objective To study the relationship between restless legs syndrome(RLS),sympathetic skin response(SSR)and R-R interval variability(RRIV),to evaluate the autonomic nervous function of RLS by neuroelectrophysiology.Methods After adjustment by removing noticeable anxiety,depression,lumbosacral radiculopathy and other interference factors,37 patients with primary RLS were compared with 30 controls.SSR and RRIV were examined in both groups,and the results of RRIV in the initial incubation period,wave amplitude,quiet breathing and deep breathing were counted and analyzed.Results In RLS group,the average latencies of upper and lower limbs were(1.475±0.108)ms and(2.027±0.216)ms and the average amplitude of upper and lower limbs were(2.319±1.836)mV and(1.156±0.789)mV.In control group,the average latencies of upper and lower limbs were(1.429±0.051)ms and(2.037±0.143)ms and the average amplitude of upper and lower limbs were(1.929±0.684)mV and(0.804±0.422)mV.There was no significant difference in the mean value of latent period and amplitude of SSR between RLS and control group(P>0.05).However,the abnormal rate of SSR in the PLS group was different from that in the control group,which showed that the amplitude of SSR was increased and/or the latency was shortened in 10 cases(27.03%),the amplitude of SSR was decreased,the latency was prolonged and/or the waveform was missing in 12 cases(32.43%)among which the waveform was missing in3 cases(8.11%).In addition,there was a significant difference in the R%and d%mean of RRIV between the PLS group and the control group:R%(P<0.01),D%(P<0.0001).The abnormality of RRIV mainly showed that R%and d%decreased;R%decreased by 26/37(70.27%);d%decreased by 33/37(89.19%).Conclusion The changes of SSR markers may be related to the abnormal emotion of RLS patients.The decrease of R%and d%in RRIV is a typical manifestation of RLS,which is less subjected to emotional influence.

关 键 词：不安腿综合征 皮肤交感反应 心率变异 交感神经 副交感神经 

分 类 号：R741[医药卫生—神经病学与精神病学]