中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2012年
10期
711-714
,共4页
陈国艳%邹慧莉%杨婷%宿长军
陳國豔%鄒慧莉%楊婷%宿長軍
진국염%추혜리%양정%숙장군
发作性睡病%REM睡眠行为障碍%多道睡眠描记术
髮作性睡病%REM睡眠行為障礙%多道睡眠描記術
발작성수병%REM수면행위장애%다도수면묘기술
Narcolepsy%REM sleep behavior disorder%Polysomnography
目的 研究发作性睡病伴快速眼球运动(REM)期行为异常(RBD)患者一般特征、多导睡眠图(PSG)参数改变及REM期动作特征和分布特点.方法 对比分析22例发作性睡病伴RBD、96例发作性睡病不伴RBD和21名健康对照一般特征、PSG参数及相关指标.分析22例发作性睡病伴RBD患者整夜连续视频PSG监测下的运动行为及分布特征.结果 发作性睡病伴RBD组与发作性睡病不伴RBD组在PSG参数及相关指标的比较上差异无统计学意义.而发作性睡病伴或不伴RBD组(24.07±5.44、23.40±4.50)与健康对照组(20.15 ±4.52)比较体质量指数明显增加(F=4.869,P =0.009),PSG参数比较睡眠潜伏期(min)及REM睡眠潜伏期(min)缩短(4.41±7.01、3.55±3.98及14.69±9.62,x2=31.697,P =0.000;69.39 ±81.39、71.04±74.45及115.31 ±45.13,x2=11.485,P=0.003),1期睡眠百分比明显增加,慢波睡眠百分比减少,觉醒时间延长,大于5 min觉醒次数增多.在发作性睡病伴RBD组中,RBD事件相当频繁地出现在整夜REM期睡眠的任意阶段.发声在睡眠的前后半程没有明显不同,而颜面部和肢体动作在睡眠的后半程增多.结论 RBD在发作性睡病患者中发生率高,睡眠结构在发作性睡病伴或不伴RBD患者中无差异.RBD出现与病程长短无关.RBD在发作性睡病患者中主要以发声或颜面部及肢体动作为主,防御或攻击行为则较少见.
目的 研究髮作性睡病伴快速眼毬運動(REM)期行為異常(RBD)患者一般特徵、多導睡眠圖(PSG)參數改變及REM期動作特徵和分佈特點.方法 對比分析22例髮作性睡病伴RBD、96例髮作性睡病不伴RBD和21名健康對照一般特徵、PSG參數及相關指標.分析22例髮作性睡病伴RBD患者整夜連續視頻PSG鑑測下的運動行為及分佈特徵.結果 髮作性睡病伴RBD組與髮作性睡病不伴RBD組在PSG參數及相關指標的比較上差異無統計學意義.而髮作性睡病伴或不伴RBD組(24.07±5.44、23.40±4.50)與健康對照組(20.15 ±4.52)比較體質量指數明顯增加(F=4.869,P =0.009),PSG參數比較睡眠潛伏期(min)及REM睡眠潛伏期(min)縮短(4.41±7.01、3.55±3.98及14.69±9.62,x2=31.697,P =0.000;69.39 ±81.39、71.04±74.45及115.31 ±45.13,x2=11.485,P=0.003),1期睡眠百分比明顯增加,慢波睡眠百分比減少,覺醒時間延長,大于5 min覺醒次數增多.在髮作性睡病伴RBD組中,RBD事件相噹頻繁地齣現在整夜REM期睡眠的任意階段.髮聲在睡眠的前後半程沒有明顯不同,而顏麵部和肢體動作在睡眠的後半程增多.結論 RBD在髮作性睡病患者中髮生率高,睡眠結構在髮作性睡病伴或不伴RBD患者中無差異.RBD齣現與病程長短無關.RBD在髮作性睡病患者中主要以髮聲或顏麵部及肢體動作為主,防禦或攻擊行為則較少見.
목적 연구발작성수병반쾌속안구운동(REM)기행위이상(RBD)환자일반특정、다도수면도(PSG)삼수개변급REM기동작특정화분포특점.방법 대비분석22례발작성수병반RBD、96례발작성수병불반RBD화21명건강대조일반특정、PSG삼수급상관지표.분석22례발작성수병반RBD환자정야련속시빈PSG감측하적운동행위급분포특정.결과 발작성수병반RBD조여발작성수병불반RBD조재PSG삼수급상관지표적비교상차이무통계학의의.이발작성수병반혹불반RBD조(24.07±5.44、23.40±4.50)여건강대조조(20.15 ±4.52)비교체질량지수명현증가(F=4.869,P =0.009),PSG삼수비교수면잠복기(min)급REM수면잠복기(min)축단(4.41±7.01、3.55±3.98급14.69±9.62,x2=31.697,P =0.000;69.39 ±81.39、71.04±74.45급115.31 ±45.13,x2=11.485,P=0.003),1기수면백분비명현증가,만파수면백분비감소,각성시간연장,대우5 min각성차수증다.재발작성수병반RBD조중,RBD사건상당빈번지출현재정야REM기수면적임의계단.발성재수면적전후반정몰유명현불동,이안면부화지체동작재수면적후반정증다.결론 RBD재발작성수병환자중발생솔고,수면결구재발작성수병반혹불반RBD환자중무차이.RBD출현여병정장단무관.RBD재발작성수병환자중주요이발성혹안면부급지체동작위주,방어혹공격행위칙교소견.
Objective To describe clinical features,polysomnographic (PSG) alterations and characteristics of motor and distribution during rapid eye movement (REM) sleep in narcoleptic patients with REM sleep behavior disorder (RBD).Methods We retrospectively summarized general features of 22 narcoleptic patients with RBD,96 narcoleptic patients without RBD and 21 healthy subjects as controls.We compared their PSG and the related indexes in 3 groups.Then we analyzed a full-night video-PSG recording in a continuous series in 22 narcoleptic patients with RBD to identify their motor behavior and distribution features.Results There was no significant difference in PSG parameter and correlation index between the narcoleptic patients with RBD group and without RBD group.However,compared with normal control group (20.15 ± 4.52),narcoleptic patients with or without RBD (24.07 ± 5.44,23.40 ± 4.50) showed increased the body mass index(F =4.869,P =0.009),shortened NREM sleep and REM sleep (min) latency at night (4.41 ±7.01,3.55 ±3.98 and 14.69 ±9.62,x2 =31.697,P =0.000;69.39 ±81.39,71.04 ±74.45and 115.31 ± 45.13,x2 =11.485,P =0.003),increased percentage of sleep stage 1,decreased percentage of slow wave sleep,delayed the arousal time and increased number of arousal episode longer than 5 minutes.In narcoleptic patients with RBD,RBD episodes occurred frequentlyatany stage of REM sleep through whole night and the frequency of vocalizations did not significantly differ between the two halves of the night.Pantomimes were significantly more frequent in RBD episodes of the second half of the night.Conclusions The prevalence of RBD is high in narcoleptic patients.Sleep architecture doesn' t differ between narcoleptic patients with and without RBD.There is no correlation between the occurrence of RBD and narcoleptic duration.In narcoleptic patients with RBD,vocalizations and pantomimes accounted formajor proportion of RBD episodes while aggressive-violent movements are rare.
