中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2011年
12期
853-856
,共4页
尹贞云%吴惠涓%张琳%彭华%黄流清%王文昭%赵忠新
尹貞雲%吳惠涓%張琳%彭華%黃流清%王文昭%趙忠新
윤정운%오혜연%장림%팽화%황류청%왕문소%조충신
入睡和睡眠障碍%哌嗪类%氮杂双环化合物%多道睡眠描记术%睡眠
入睡和睡眠障礙%哌嗪類%氮雜雙環化閤物%多道睡眠描記術%睡眠
입수화수면장애%고진류%담잡쌍배화합물%다도수면묘기술%수면
Sleep initiation and maintenance disorders%Piperazines%Azabicyclo compounds%Polysomnography%Sleep
目的 使用临床评估量表和多导睡眠检测技术研究镇静催眠药物右佐匹克隆治疗适应性失眠患者的有效性及其对睡眠结构的影响.方法 采用治疗前后自身对照设计,比较适应性失眠患者使用右佐匹克隆治疗前后的睡眠结构变化及评估其药物疗效.纳入对象为上海长征医院神经内科睡眠障碍门诊中符合诊断标准的患者共32例,其中女性20例,男性12例,平均年龄36.2岁.患者接受连续3d药物治疗(每次3 mg右佐匹克隆),观察指标为服药前及服药第3天睡眠相关的主观与客观检查(量表评估和多导睡眠图检查),记录并分析患者的总卧床时间、总睡眠时间、觉醒时间、入睡潜伏期、睡眠效率、非快速眼动(NREM)睡眠各期时间百分比、快速眼动(REM)睡眠时间百分比等,并使用失眠严重程度指数量表( ISI)和MMSE评价患者的失眠严重程度和药物对于患者日间认知功能的影响.结果 右佐匹克隆能够缩短入睡潜伏期[治疗前( 52.92±11.71) min,治疗后(28.2±10.11)min；t=-4.376,P＜0.01]、延长总睡眠时间[治疗前(365.22±30.13) min,治疗后(429.18±26.93)min;t=4.102,P＜0.01]、减少觉醒次数[治疗前(5.00±1.92)次,治疗后(2.73±0.91)次；t=-4.592,P＜0.01]、提高睡眠效率(治疗前72.69％±6.32％,治疗后82.67％±4.16％；t=3.371,P＜0.01)、缩短觉醒时间[治疗前(88.51±17.48) min,治疗后(65.93±21.10) min；t=-5.863,P＜0.01]、降低NREM 1期时间百分比(治疗前12.54％±2.10％,治疗后7.30％±2.90％；t=-3.155,P＜0.01)、增加慢波睡眠时间百分比(治疗前8.03％±5.37％,治疗后9.31％±5.29％；t=4.228,P＜0.01),而对NREM 2期睡眠时间百分比、REM睡眠时间百分比无明显影响.右佐匹克隆能够提高患者对睡眠质量的主观评价(ISI评分降低,t=-2.551,P＜0.05),且服药后对患者次日清晨的认知功能无明显影响(MMSE评分未见降低).结论 右佐匹克隆能够正性调节急性失眠患者的睡眠结构,提高患者的主观睡眠质量,对日间认知功能无明显影响,安全性好.
目的 使用臨床評估量錶和多導睡眠檢測技術研究鎮靜催眠藥物右佐匹剋隆治療適應性失眠患者的有效性及其對睡眠結構的影響.方法 採用治療前後自身對照設計,比較適應性失眠患者使用右佐匹剋隆治療前後的睡眠結構變化及評估其藥物療效.納入對象為上海長徵醫院神經內科睡眠障礙門診中符閤診斷標準的患者共32例,其中女性20例,男性12例,平均年齡36.2歲.患者接受連續3d藥物治療(每次3 mg右佐匹剋隆),觀察指標為服藥前及服藥第3天睡眠相關的主觀與客觀檢查(量錶評估和多導睡眠圖檢查),記錄併分析患者的總臥床時間、總睡眠時間、覺醒時間、入睡潛伏期、睡眠效率、非快速眼動(NREM)睡眠各期時間百分比、快速眼動(REM)睡眠時間百分比等,併使用失眠嚴重程度指數量錶( ISI)和MMSE評價患者的失眠嚴重程度和藥物對于患者日間認知功能的影響.結果 右佐匹剋隆能夠縮短入睡潛伏期[治療前( 52.92±11.71) min,治療後(28.2±10.11)min；t=-4.376,P＜0.01]、延長總睡眠時間[治療前(365.22±30.13) min,治療後(429.18±26.93)min;t=4.102,P＜0.01]、減少覺醒次數[治療前(5.00±1.92)次,治療後(2.73±0.91)次；t=-4.592,P＜0.01]、提高睡眠效率(治療前72.69％±6.32％,治療後82.67％±4.16％；t=3.371,P＜0.01)、縮短覺醒時間[治療前(88.51±17.48) min,治療後(65.93±21.10) min；t=-5.863,P＜0.01]、降低NREM 1期時間百分比(治療前12.54％±2.10％,治療後7.30％±2.90％；t=-3.155,P＜0.01)、增加慢波睡眠時間百分比(治療前8.03％±5.37％,治療後9.31％±5.29％；t=4.228,P＜0.01),而對NREM 2期睡眠時間百分比、REM睡眠時間百分比無明顯影響.右佐匹剋隆能夠提高患者對睡眠質量的主觀評價(ISI評分降低,t=-2.551,P＜0.05),且服藥後對患者次日清晨的認知功能無明顯影響(MMSE評分未見降低).結論 右佐匹剋隆能夠正性調節急性失眠患者的睡眠結構,提高患者的主觀睡眠質量,對日間認知功能無明顯影響,安全性好.
목적 사용림상평고량표화다도수면검측기술연구진정최면약물우좌필극륭치료괄응성실면환자적유효성급기대수면결구적영향.방법 채용치료전후자신대조설계,비교괄응성실면환자사용우좌필극륭치료전후적수면결구변화급평고기약물료효.납입대상위상해장정의원신경내과수면장애문진중부합진단표준적환자공32례,기중녀성20례,남성12례,평균년령36.2세.환자접수련속3d약물치료(매차3 mg우좌필극륭),관찰지표위복약전급복약제3천수면상관적주관여객관검사(량표평고화다도수면도검사),기록병분석환자적총와상시간、총수면시간、각성시간、입수잠복기、수면효솔、비쾌속안동(NREM)수면각기시간백분비、쾌속안동(REM)수면시간백분비등,병사용실면엄중정도지수량표( ISI)화MMSE평개환자적실면엄중정도화약물대우환자일간인지공능적영향.결과 우좌필극륭능구축단입수잠복기[치료전( 52.92±11.71) min,치료후(28.2±10.11)min；t=-4.376,P＜0.01]、연장총수면시간[치료전(365.22±30.13) min,치료후(429.18±26.93)min;t=4.102,P＜0.01]、감소각성차수[치료전(5.00±1.92)차,치료후(2.73±0.91)차；t=-4.592,P＜0.01]、제고수면효솔(치료전72.69％±6.32％,치료후82.67％±4.16％；t=3.371,P＜0.01)、축단각성시간[치료전(88.51±17.48) min,치료후(65.93±21.10) min；t=-5.863,P＜0.01]、강저NREM 1기시간백분비(치료전12.54％±2.10％,치료후7.30％±2.90％；t=-3.155,P＜0.01)、증가만파수면시간백분비(치료전8.03％±5.37％,치료후9.31％±5.29％；t=4.228,P＜0.01),이대NREM 2기수면시간백분비、REM수면시간백분비무명현영향.우좌필극륭능구제고환자대수면질량적주관평개(ISI평분강저,t=-2.551,P＜0.05),차복약후대환자차일청신적인지공능무명현영향(MMSE평분미견강저).결론 우좌필극륭능구정성조절급성실면환자적수면결구,제고환자적주관수면질량,대일간인지공능무명현영향,안전성호.
Objective To evaluate the efficacy of eszopiclone for patients with acute insomnia and the impact of premedication with eszopiclone on sleep structure of patients with acute insomnia.Methods In an open-label,self-control trial was conducted at Changzheng Hospital Sleep Centers,and patients (n =32) with acute insomnia (12 men,20 women; mean age,36.2 years) were administered eszopiclone 3 mg for three consecutive nights.Sleep was monitored via polysomnography.The insomnia severity index (ISI),and mini-mental state examination (MMSE) were used to assess the degree of insomnia and impact of drugs on cognitive function during the day.Results Eszopiclone can shorten sleep latency ( before treatment:(52.92 ± 11.71 ) min,after treatment:(28.2 ± 10.11 ) min; t =-4.376,P ＜0.01 ),prolong total sleep time(before treatment:(365.22 ±30.13) min,after treatment:(429.18 ±26.93 ) min; t =4.102,P ＜ 0.01 ),decrease wake up times( before treatment:( 5.00 ± 1.92 ) times,after treatment:( 2.73 ± 0.91 )times; t =- 4.592,P ＜ 0.01 ),improve sleep efficiency ( before treatment:72.69％ ± 6.32％,after treatment:82.67％ ± 4.16％ ; t =3.371,P ＜ 0.01 ),reduce awake time ( before treatment:( 88.51 ±17.48) min,after treatment:(65.93 ±21.l0)min; t =-4.592,P ＜0.01 ),decrease light sleep ( NREM1 period) the percentage of time ( before treatment:12.54％ ± 2.10％,after treatment:7.30％ ± 2.90％ ;t=-3.155,P ＜ 0.01 ),and increase the percentage of slow wave sleep (before treatment:8.03％ ±5.37％,after treatment:9.31％ ±5.29％; t =4.228,P ＜0.01).No effect was observed on the percentage of NERM2 period (t =0.731,P ＞0.05) and REM period (t =-0.813,P ＞0.05).Eszopiclone can improve the quality of subjective assessment of sleep ( ISI score decreased,t =- 2.551,P ＜ 0.05) and has no significant effect on cognitive function on first the morning after patients taking the medication.Conclusion Eszopiclone can positively regulate the sleep structure in patients with acute insomnia and improve subjective assessment of sleep quality.It is safe and has no significant effect on cognitive function.
