选择性5-羟色胺再摄取抑制剂药物相关非快眼动睡眠期过度眼动的临床和电生理特征分析  

Analysis of clinical and electrophysiological characteristics of selective serotonin reuptake inhibitor drug-associated hypereye movement during non-rapid eye movement sleep

作　　者：李敏 袁娜 王晓丽 刘永红 Li Min;Yuan Na;Wang Xiaoli;Liu Yonghong(Department of Neurology,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院神经内科,西安710032

出　　处：《中国医师杂志》2024年第10期1483-1487,共5页Journal of Chinese Physician

基　　金：国家重点研发计划(2022YFC2503806);航空医学重大课题(2019ZTB03,2020JSTS21);陕西省重点研发计划(2023-YBSF-199)。

摘　　要：目的探讨7例选择性5-羟色胺再摄取抑制剂(SSRI)药物相关非快眼动(NREM)睡眠期过度眼动的临床和电生理特征。方法总结空军军医大学第一附属医院神经内科睡眠中心2021年6月至2022年5月收治的7例SSRI药物相关NREM睡眠期过度眼动患者的临床和电生理资料。结果7例患者年龄10~76(中位数34)岁,4例为女性。4例患者诊断为焦虑抑郁状态,3例患者诊断为发作性睡病(其中1例患者共病周期性肢体运动障碍)。4例患者应用舍曲林,1例患者应用氟西汀,1例患者应用草酸艾司西酞普兰,1例患者应用盐酸帕罗西汀,所有患者均检测到SSRI药物相关NREM睡眠期过度眼动,表现为慢速眼球运动和快速眼球运动共存,1期眼动密度大于2期眼动密度。所有患者均存在睡眠结构紊乱,NREM1期睡眠比例增多,大量微觉醒。结论SSRI药物应用期间部分患者存在特征性NREM睡眠期异常眼动,多发生于NREM1期和2期睡眠,需注意与正常快速眼动(REM)期睡眠相鉴别。Objective To investigate the clinical and electrophysiological characteristics of 7 patients with non-rapid eye movement(NREM)sleep induced by selective serotonin reuptake inhibitor(SSRI).Methods The clinical and electrophysiological data of 7 patients with SSRI drug-related NREM excessive eye movement admitted to Sleep Center,Department of Neurology,the First Affiliated Hospital of Air Force Medical University,from June 2021 to May 2022 were summarized.Results Seven patients ranged in age from 10 to 76 years(median 34 years),and four were female.Four patients were diagnosed with anxiety and depression,and three patients were diagnosed with narcolepsy(one patient was comorbidized with periodic limb movement disorder).Sertraline was used in 4 patients,fluoxetine in 1 patient,escitalopram in 1 patient,and paroxetine hydrochloride in 1 patient.SSRI drug-related excessive eye movement in NREM stage was detected in all patients,which was characterized by coexistence of slow eye movement and fast eye movement,and eye movement density in stage 1 was greater than that in stage 2.All patients had sleep structure disorder,increased proportion of NREM phase 1 sleep and a large number of micro-awakenings.Conclusions During SSRI drug use,some patients have characteristic abnormal eye movement in NREM,mostly in NREM 1 and 2 sleep,which should be distinguished from normal rapid eye movement(REM)sleep.

关 键 词：选择性5-羟色胺再摄取抑制剂 多导睡眠监测 非快速眼动睡眠期 

分 类 号：R740[医药卫生—神经病学与精神病学]