基于多导睡眠图的抗癫痫发作药物与偏侧化发作间期癫痫样放电对癫痫患者睡眠的影响  

Exploring the effects of anti-seizure medication and lateralized epileptiform discharges during interictal on sleep in epileptic patients based on polysomnography

作　　者：王思航 吴美娜[1] 吴桑茹 林芳[1] 季晓林[1] 严金柱[1] WANG Sihang;WU Meina;WU Sangru(Sleep Medical Center,Department of Neurology,Fujian Provincial Government Hospital(the Affiliated Hospital of Fujian Health College),Fuzhou(350003),Fujian,China)

机构地区：[1]福建省级机关医院(福建卫生职业技术学院附属医院)神经内科,睡眠医学中心,福建福州350003

出　　处：《癫痫与神经电生理学杂志》2023年第6期321-329,339,共10页Journal of Epileptology and Electroneurophysiology(China)

基　　金：福建省自然科学基金资助项目(2019J01095)。

摘　　要：目的通过多导睡眠图(PSG)探讨抗癫痫发作药物(ASM)及偏侧化发作间期癫痫样放电(IED)对癫痫患者睡眠结构及睡眠期相关事件的影响。方法选取2018年3月至2022年12月在福建省级机关医院神经内科、睡眠医学中心门诊或病房治疗的癫痫患者75例,其中32例服用ASM、43例未服用ASM,对两组患者进行PSG(含视频及16个导联的脑电图)+动态脑电图监测,比较两组患者的睡眠结构及睡眠期相关事件。并对两组患者单、双侧IED的睡眠结构及睡眠期相关事件的不同结果进行分析。结果两组患者的睡眠结构比较差异无统计学意义(P>0.05);而服药癫痫组的血氧饱和度高于未服药癫痫组[95(94,96)%vs 94(93,95)%],在未服药癫痫组中,单、双侧IED组的睡眠结构及睡眠期相关事件比较差异均无统计学意义(P>0.05);在服药癫痫组中,单侧IED组的非快速眼动睡眠1期比例(N1%)[(21.48±15.61)%vs(12.06±6.55%)]、觉醒指数[12.9(7.75,18.3)次/h vs 8.8(6.5,10.9)次/h]均高于双侧IED组,差异有统计学意义(P<0.05)。结论ASM对IED患者的睡眠结构影响不大,服药癫痫组的血氧饱和度高于未服药癫痫组。服用ASM的患者单侧IED对睡眠期各结构的影响更大,主要表现为N1%及觉醒指数增高。Objective To explore the effects of anti-seizure medication(ASM)and lateralized interictal epileptiform discharge(IED)on sleep structure and sleep-related events in epileptic patients based on polysomnography(PSG).Methods A total of 75 outpatients and inpatients with epilepsy at the department of Neurology,Sleep Medicine Center of Fujian Provincial Government Hospital from March 2018 to December 2022 were selected.Among which,PSG monitoring(including video and 16 EGG leads)and ambulatory eleroencephalography(AEGG)were run on 33 patients who took ASM and 43 first-visit epilepsy patients who did not take ASM.Sleep structure and sleep-related events were compared between two groups.The different results of sleep structures and sleep-related events of unilateral and bilateral IEDs in two groups of patients were analyzed.Results The difference in sleep structure between two groups was not statistically significant(P>0.05).The blood oxygen saturation was higher in the patients who took ASM than that in the patients who did not take ASM[95(94,96)%vs 94(93,95)%].In epilepsy group not treated with medication,there was no statistically significant differences in sleep structure and sleep-related events between the unilateral and bilateral IED(P>0.05).The proportion of non-rapid eye movement phase 1(N1%)and arousal index in unilateral IED group(N1%)were higher than those in bilateral IED group[(21.48±15.61)%vs(12.06±6.55)%];[12.9(7.75,18.3)times/hour vs 8.8(6.5,10.9)times/hour],respectively.Conclusions ASM has little impact on the sleep structure in patients with IED.The blood oxygen saturation of the patients taking ASM was higher than that of the patients who did not take ASM at the first visit.Unilateral IEDs have a great impact on the various sleep structures in the patients taking ASM,mainly manifested as the increases in N1%and arousal index.

关 键 词：癫痫 多导睡眠图 抗癫痫发作药物 发作间期癫痫样放电 睡眠结构 睡眠事件 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]