睡眠剥夺对正常成年人前庭功能影响的初步研究  

Effect of Sleep Deprivation on Vestibular Function in Normal Adults-A Pilot Study

作　　者：吴诗欣 黎志成[2] 张姝琪 李凌伟 吴慧青[2] 曾祥丽[2] WU Shi-xin;LI Zhi-cheng;ZHANG Shu-qi;LI Ling-wei;WU Hui-qing;ZENG Xiang-li(Department of Radiology,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Head and Neck Surgery,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,510630 China)

机构地区：[1]中山大学附属第三医院放射科,广东广州510630 [2]中山大学附属第三医院耳鼻咽喉头颈外科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2022年第5期807-817,共11页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2015A020220005)。

摘　　要：【目的】探讨睡眠剥夺对正常成年人前庭功能的影响。【方法】试验前对每位受试者进行匹兹堡睡眠质量量表(PSQI)、基本资料的采集和记录,试验组38位护士在正常睡眠和值夜班后分别进行颈源性前庭诱发肌源电位(cVEMP)、眼源性前庭诱发肌源性电位(oVEMP)、视频头脉冲试验(vHIT)检查前庭功能,进行自身对照,同时选取20位正常睡眠成年人作为对照组,进行前庭诱发肌源性电位检查前庭功能,进行组间的对比分析。【结果】①38位护士与对照组在PSQI得分的差异有统计学意义(P<0.05),其中试验组有11位存在睡眠障碍(PSQI总分>7分);②睡眠剥夺状态下,受试者oVEMP的异常率高于正常睡眠状态(P=0.02),cVEMP的异常率有升高趋势,cVEMP、oVEMP两耳间不对称率较正常睡眠时升高(P<0.05),vHIT的异常率则未见统计学差异(P>0.05);③38位护士中,易出现前庭功能异常(异常组)的受试者工龄、每月夜班天数高于未出现前庭功能异常(正常组)的受试者(P<0.05)。在异常组中,cVEMP有5例为左侧振幅下降(71%),2例为右侧振幅下降(29%);oVEMP有13例为左侧振幅下降(76%),4例为右侧振幅下降(24%);④同为正常睡眠状态时,试验组的cVEMP表现与对照组相比均出现P 1潜伏期及波间期延长,差异具有统计学意义(P<0.05),试验组的oVEMP表现与对照组相比均出现N 1潜伏期及波间期延长(P<0.05),表现为潜伏期、波间期的延长,余参数未见明显统计学差异(P>0.05)。【结论】①睡眠剥夺对耳石器功能有潜在、积累的损伤;②工龄长及每月夜班数多是睡眠剥夺影响个体前庭功能的风险因素;③前庭诱发肌源性电位检查可能可作为判断睡眠相关的前庭功能损伤的筛查手段,在保证近期睡眠质量良好的状态下行前庭诱发肌源性电位检查时结果更可靠。【Objective】To explore the effect of sleep deprivation on vestibular function in normal adults.【Methods】The Pittsburgh sleep quality index(PSQI)and basic data were collected and recorded before the experiment.The 38 medi⁃cal workers in the experimental group were examined by cervical vestibular evoked myogenic potential(cVEMP),ocular vestibular evoked myogenic potential,(oVEMP)and video-head impulse test(vHIT)to check vestibular function after normal sleep and night shift,respectively,and the results were compared for their own control.At the same time,20 normal adults were selected as the control group,and vestibular evoked myogenic potentials(VEMPs)were performed to check vestibular function for comparative analysis between groups.【Results】①The difference in PSQI scores between the 38 health workers and the control group was statistically significant(P<0.05).The test group had 11 sleep disorders(PSQI score>7);②In the sleep deprivation state,the abnormal rate of oVEMP was higher than that of normal sleep(P=0.02),the abnormal rate of cVEMP tended to increase,and the rate of interaural asymmetry of cVEMP and oVEMP was higher than that of normal sleep(P<0.05),while no significant difference was seen in the abnormal rate of vHIT(P>0.05);③Among the 38 healthcare workers,subjects prone to vestibular function abnormalities(abnormal group)had a higher number of years of service and number of night shift days per month than those without vestibular function abnormal⁃ities(normal group)(P<0.05).In the abnormal group,there were 5 cases of left-sided amplitude decrease(71%)and 2 cases of right-sided amplitude decrease(29%)in cVEMP;there were 13 cases of left-sided amplitude decrease(76%)and 4 cases of right-sided amplitude decrease(24%)in oVEMP;④In the same normal sleep state,cVEMP performance in the test group showed statistically significant differences in prolonged P 1 latency and interwave period compared with the control group(P<0.05).The oVEMP performance of the test group showed statistically s

关 键 词：睡眠剥夺 前庭功能 前庭诱发电位 视频头脉冲试验 

分 类 号：R764[医药卫生—耳鼻咽喉科]