睡眠纺锤波的影响因素分析  

Analysis of influencing factors of sleep spindles

作　　者：马慧娟 刘春燕 王桂芳[3] 王丽[4] MA Huijuan;LIU Chunyan;WANG Guifang(Department of Neurology,Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Technical Aids,Beijing 100176,China)

机构地区：[1]北京社会管理职业学院(民政部培训中心),国家康复辅具研究中心附属康复医院神经内科,102600 [2]首都医科大学宣武医院神经内科,脑功能疾病调控治疗北京市重点实验室 [3]新乡市中心医院儿科 [4]北京理工大学医学技术学院

出　　处：《临床神经病学杂志》2024年第2期102-106,共5页Journal of Clinical Neurology

摘　　要：目的睡眠纺锤波有促进认知的功能,本文探讨睡眠纺锤波的影响因素,为临床干预和调节纺锤波,进而改善睡眠和认知提供佐证。方法对50例睡眠质量不佳的患者使用多导睡眠监测系统进行整夜睡眠呼吸监测,得到睡眠结构相关参数、脑电功率谱、心血管及呼吸功能的生理参数。分别计算各参数以及年龄、性别与非快速眼动睡眠(NREM)Ⅱ期纺锤波指数及特征(频率、时长和波幅)的相关性。其中庞加莱图中的SD1代表副交感神经活性的正指标,SD2代表交感神经活性的逆指标;脉搏传导时间(PTT)下降指数代表血管交感神经稳定性。结果SD1(β=-0.512,P<0.05)和PTT下降指数(β=-0.271,P<0.05)与纺锤波指数分别呈负相关,SD2与纺锤波指数呈正相关(β=0.474,P<0.05)。睡眠期变化指数、NREMⅠ期占比和皮质EEG微觉醒指数均与纺锤波指数呈低度负相关(r=-0.316,r=-0.359,r=-0.326;均P<0.05)。年龄与纺锤波指数呈负相关(β=-0.422,P<0.05)。深睡期δ功率与纺锤波幅度呈正相关(β=0.65,P<0.001)。未发现性别与纺锤波有相关性。结论睡眠纺锤波的产生依赖于良好的睡眠及稳定的自主神经。其与认知相关,能反映神经突触连接的强度,这为临床干预和调节纺锤波提供了佐证,也为评价认知和大脑功能提供了新的生理指标。Objective Sleep spindles play an important role in promoting cognition.This paper discusses the influencing factors of sleep spindles and provides objective evidence for clinical intervention and regulation of spindles to improve sleep and cognition.Methods Fifty patients with poor sleep quality were monitored overnight by sleep monitoring system,and physiological parameters of sleep structure,electroencephalography power spectrum,cardiovascular and respiratory function were obtained.The correlations between the parameters,age,sex and the spindle index and characteristics(frequency,duration and amplitude)of non rapid-eye-movement sleep(NREM)I phase were calculated.In Poincare diagram,SD1 represents the positive index of parasympathetic nerve activity,and SD2 represents the negative index of sympathetic nerve activity.Pulse transit time(PTT)decline index represents vascular sympathetic stability.Results SD1(β=-0.512,P<0.05)and PTT decline index(β=-0.271,P<0.05)were negatively correlated with spindle index respectively,while SD2 was positively correlated with spindle index(β=0.474,P<0.05).The sleep change index,NREM I phase proportion and cortical EEG microarousal index were negatively correlated with spindle index(r=-0.316,r=-0.359,r=-0.326;all P<0.05).Age was negatively correlated with spindle index(β=-0.422,P<0.05).power of deep sleep was negatively correlated with Spindle wave amplitude(β=0.65,P<0.001).No correlation was found between sex and sleep spindles.Conclusions The production of sleep spindles depends on good sleep and stable autonomic nerves.It is related to cognition and reflects the strength of synaptic connections,which provides evidence for clinical intervention and regulation of sleep spindles,and also provides a new physiological indicator for evaluating cognitive and brain function.

关 键 词：睡眠纺锤波 自主神经 庞加莱图 多导睡眠监测 脉搏传导时间下降指数 

分 类 号：R740[医药卫生—神经病学与精神病学]