睡眠期癫痫样电持续状态的棘慢波指数计算方法研究  

A study of different calculation methods of spike and wave indexinelectrical status epilepticus during sleep

作　　者：屈凯旋 张进[2] 窦长新 赵绚 王黎[2] 林一聪[2] 王玉平[2] QU Kaixuan;ZHANG Jin;DOU Changxin(Department of Neuroelectrophysiology,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院),河南郑州450000 [2]首都医科大学宣武医院神经内科,北京100053 [3]邹城市人民医院,山东济宁273500 [4]首都医科大学宣武医院儿科,北京100053

出　　处：《中风与神经疾病杂志》2023年第3期202-206,共5页Journal of Apoplexy and Nervous Diseases

基　　金：北京市自然科学基金重点研究专题项目(Z200024);国家支持省级重大疾病医疗服务与保障能力提升项目。

摘　　要：目的棘慢波指数(SWI)是儿童睡眠中癫痫性电持续状态(ESES)的主要诊断依据,本研究拟将目前应用较多的4种SWI计数方法与完整睡眠期SWI进行比较,评价其准确性。方法通过回顾分析脑电图报告诊断为ESES(报告示棘慢波指数≥50%)的15例患者,计数整夜睡眠期(SWI)、第一个睡眠周期(SWI_(1))、第一个睡眠周期前5 min(SWI_(5 min))、前10 min(SWI _(10 min))和前15 min(SWI _(15 min))的SWI。采用Wilcoxon配对检验方法将SWI_(1)、SWI_(5 min)、SWI_(10 min)、SWI_(15 min)分别和SWI进行比较。结果4种方法的SWI与整夜睡眠期SWI均存在显著性差异(P值分别为0.003、0.002、0.002和0.001,α=0.0125)。在15例患者中14例(93.3%)在整夜睡眠期中存在SWI随睡眠加深而减少的变化趋势。结论4种方法SWI均不能很好地替代整夜睡眠期SWI。随睡眠周期加深SWI呈现递减趋势,使用第一个睡眠周期或其中的时间片段计算SWI很可能高估放电指数。Objective Spike and wave index(SWI)is of great importance for the diagnosis of electrical status epilepticus during sleep(ESES)in children patients.This study intended to compare four commonly used SWI methods with full night SWI to evaluate their performances.Methods Fifteen patients diagnosed with ESES by electroencephalogram initial report(SWI≥50%)were retrospectively analyzed,and SWI was calculated for the full night sleep(SWI),the first sleep cycle(SWI_(1)),the first 5 minutes of the first sleep cycle(SWI_(15 min)),the first 10 minutes(SWI_(10 min))and the first 15 minutes(SWI_(15 min)).Wilcox paired test was used to compare SWI with other four SWI methods respectively.Results The SWI of all four methods was significantly different from the full night SWI(p-values of 0.003、0.002、0.002 and 0.001,respectively,α=0.0125).Among the 15 patients,14(93.3%)had the trend that SWI decreased with sleep cycles overnight.Conclusion None of the four methods of SWI is a good substitute for full night SWI.The SWI tends to decrease with sleep cycles overnight,and using the first sleep cycle or anepoch of it to calculate SWI is likely to be overestimated.

关 键 词：癫痫性电持续状态 棘慢波指数 睡眠周期 

分 类 号：R742.1[医药卫生—神经病学与精神病学]