临床精神医学杂志
臨床精神醫學雜誌
림상정신의학잡지
JOURNAL OF CLINICAL PSYCHOLOGICAL MEDICINE
2015年
3期
163-165
,共3页
高存友%甘景梨%李东河%范亮亮%马学涛%白晶
高存友%甘景梨%李東河%範亮亮%馬學濤%白晶
고존우%감경리%리동하%범량량%마학도%백정
应激相关失眠症%心率变异度%皮质醇
應激相關失眠癥%心率變異度%皮質醇
응격상관실면증%심솔변이도%피질순
stress-related sleep disturbance%heart rate variability%plasma cortisol
目的:探讨应激性失眠易患个体交感神经系统( SNS)与肾上腺皮质系统( HPA)的觉醒水平状况,以及生理觉醒水平变化指标是否是个体易患失眠症的病前预警标识。方法:345名睡眠良好的健康志愿者根据福特应激失眠反应量表( FIRST)评分分为高分组(>17分)172人和低分组(≤17分)173人;采用动态心电图分析仪收集并分析心率变异度( HRV)的低频( LF)、高频( HF)、以及LF/HF比值等频域指标;同时检测血浆皮质醇浓度( COR);对两组上述指标进行比较。结果:与低分组比较,高分组年龄偏小( t=-3.59,P=0.000)、女性比率较高(χ2=11.62,P=0.000)。将两组对象匹配后(高分组74人,低分组76人)比较,高分组HRV的HF、LF偏低( t=13.26,t=68.86),LF/HF及血浆COR浓度偏高(t=-13.46,t=-2.21),差异有统计学意义(P<0.001或P<0.05)。线性回归方程分析显示,性别、LF/HF、COR浓度与FIRST评分呈正相关( t=3.523,t=4.826,t=2.534;P<0.01或P<0.05)。结论:应激性失眠易患者HPA和SNS的觉醒水平升高,LF/HF和血浆COR浓度可能是失眠易患性的预警指标。
目的:探討應激性失眠易患箇體交感神經繫統( SNS)與腎上腺皮質繫統( HPA)的覺醒水平狀況,以及生理覺醒水平變化指標是否是箇體易患失眠癥的病前預警標識。方法:345名睡眠良好的健康誌願者根據福特應激失眠反應量錶( FIRST)評分分為高分組(>17分)172人和低分組(≤17分)173人;採用動態心電圖分析儀收集併分析心率變異度( HRV)的低頻( LF)、高頻( HF)、以及LF/HF比值等頻域指標;同時檢測血漿皮質醇濃度( COR);對兩組上述指標進行比較。結果:與低分組比較,高分組年齡偏小( t=-3.59,P=0.000)、女性比率較高(χ2=11.62,P=0.000)。將兩組對象匹配後(高分組74人,低分組76人)比較,高分組HRV的HF、LF偏低( t=13.26,t=68.86),LF/HF及血漿COR濃度偏高(t=-13.46,t=-2.21),差異有統計學意義(P<0.001或P<0.05)。線性迴歸方程分析顯示,性彆、LF/HF、COR濃度與FIRST評分呈正相關( t=3.523,t=4.826,t=2.534;P<0.01或P<0.05)。結論:應激性失眠易患者HPA和SNS的覺醒水平升高,LF/HF和血漿COR濃度可能是失眠易患性的預警指標。
목적:탐토응격성실면역환개체교감신경계통( SNS)여신상선피질계통( HPA)적각성수평상황,이급생리각성수평변화지표시부시개체역환실면증적병전예경표식。방법:345명수면량호적건강지원자근거복특응격실면반응량표( FIRST)평분분위고분조(>17분)172인화저분조(≤17분)173인;채용동태심전도분석의수집병분석심솔변이도( HRV)적저빈( LF)、고빈( HF)、이급LF/HF비치등빈역지표;동시검측혈장피질순농도( COR);대량조상술지표진행비교。결과:여저분조비교,고분조년령편소( t=-3.59,P=0.000)、녀성비솔교고(χ2=11.62,P=0.000)。장량조대상필배후(고분조74인,저분조76인)비교,고분조HRV적HF、LF편저( t=13.26,t=68.86),LF/HF급혈장COR농도편고(t=-13.46,t=-2.21),차이유통계학의의(P<0.001혹P<0.05)。선성회귀방정분석현시,성별、LF/HF、COR농도여FIRST평분정정상관( t=3.523,t=4.826,t=2.534;P<0.01혹P<0.05)。결론:응격성실면역환자HPA화SNS적각성수평승고,LF/HF화혈장COR농도가능시실면역환성적예경지표。
Objective:To investigate the characteristics of sympathetic-nervous system( SNS)and hypo-thalamus-pituitary-adrenal system( HPA)in people with the stress-related sleep disturbance vulnerability,and to explore the predictors of the stress-related sleep disturbance for individuals susceptible to insomnia. Method:A total of 345 healthy volunteers were divided into high score group( >17 score)and low score group (≤17 score)by the Ford stress insomnia symptoms scale( FIRST). The dynamic electrocardiograph was used to analyze low frequency( LF),high frequency( HF)and LF/HF of heart rate variability( HRV). Blood at 8:00 am was taken to test the plasma cortisol( COR)level. Resuits:Compared with low score group,high score group was younger(t= -3. 59,P=0. 000)and had higher percentage of females(χ2 =11. 62,P=0. 000). Plasma COR level and LF/HF index were significantly higher(t= -13. 46,t= -2. 21),while the LF and HF index were significantly lower(t =13. 26,t =68. 86)in high score group than those in low score group (P<0. 001 or P<0. 05). Results of linear regression analysis showed that gender,LF/HF index and plasma COR level were significantly correlated with FIRST score( t =3. 523,t =4. 826,t =2. 534;P <0. 01 or P<0. 05). Conciusion:HPA and SNS arousal level are higher in individuals with stress-related sleep disturb-ance vulnerability. LF/HF and COR level may be early warning index of predisposition to sleep disturbance.