CAJ | 학술논문

目的研究脑干病变快速动眼期(REM)睡眠行为障碍(RBD)的患病率,以及RBD的发生与脑干病灶位置的关系.方法 2009年1月至2013年1月间收集在北京协和医院神经科诊治的脑干病变患者62例,同时期健康体检的对照组66例,进行快速眼动期睡眠行为筛查量表(RBDSQ)问卷调查,满足RBD诊断标准的进行多导睡眠图(PSG)及抑郁自评量表(SDS)、焦虑自评量表(SAS)测评.结果脑干病变组平均年龄43 ±16(18 ～65)岁;对照组平均年龄41 ±13(18 ～65)岁.脑干病变组RBD 5例,占8.1％,均存在桥脑被盖部病灶;对照组RBD 2例,占3％.脑干组RBD患者SDS评分38 ±4(35 ～44)分,SAS评分43.0 ±5.8(36 ～49)分;对照组RBD患者SDS评分64±6(59 ～68)分,SAS评分69.5 ±2.1 (68 ～71)分.给予小剂量氯硝安定治疗,RBD症状消失.结论脑干病变中RBD并不少见,确诊需结合临床及PSG检查.
목적 연구뇌간병변쾌속동안기(REM)수면행위장애(RBD)적환병솔,이급RBD적발생여뇌간병조위치적관계.방법 2009년1월지2013년1월간수집재북경협화의원신경과진치적뇌간병변환자62례,동시기건강체검적대조조66례,진행쾌속안동기수면행위사사량표(RBDSQ)문권조사,만족RBD진단표준적진행다도수면도(PSG)급억욱자평량표(SDS)、초필자평량표(SAS)측평.결과 뇌간병변조평균년령43 ±16(18 ～65)세;대조조평균년령41 ±13(18 ～65)세.뇌간병변조RBD 5례,점8.1％,균존재교뇌피개부병조;대조조RBD 2례,점3％.뇌간조RBD환자SDS평분38 ±4(35 ～44)분,SAS평분43.0 ±5.8(36 ～49)분;대조조RBD환자SDS평분64±6(59 ～68)분,SAS평분69.5 ±2.1 (68 ～71)분.급여소제량록초안정치료,RBD증상소실.결론 뇌간병변중RBD병불소견,학진수결합림상급PSG검사.
Objective To explore the prevalence of REM sleep behavior disorder (RBD) and define the brainstem structures likely to be involved in its pathogenesis in patients with brainstem lesions on magnetic resonance imaging (MRI).Methods Sixty-two patients with definite brainstems lesions on brain MRI were recruited from Neurology Department,Peking Union Medical College Hospital.And 66 genderand-age-matched healthy subjects were included as controls.RBD screening questionnaire (RBDSQ) was provided.All patients fulfilling clinical criteria for RBD underwent a two-night polysomnography (PSG) with synchronized audio-visual recording and the evaluations of Zung self-rating depression scale (SDS) and Zung self-rating anxiety scale (SAS).Results The brainstem group had a mean age of 43 ± 16 years (range,18-65) while the controls a mean age of 41 ± 13 years (range,18-65).In brainstem group,SDS scores were 38 ± 4 (range,35-44) ; SAS scores 43.0 ± 5.8 (range,36-49).In controls,SDS scores were 64 ±6 (range,59-68) ; SAS scores 69.5 ±2.1 (range,68-71).Five patients in the brainstem group and two in the control group fulfilling the clinical criteria for RBD were confirmed after PSG.All five patients had focal lesion on pontine tegmentum.Treatment with clonazepam at bedtime completely resolved the RBD symptoms.Conclusion RBD is common in patients with brainstem lesions.And its definite diagnosis is based upon clinical symptoms and PSG examination.