期刊文献+

选择性5-羟色胺再摄取抑制剂对抑郁症患者睡眠结构的影响及与临床疗效的关系研究 被引量:24

Influence of Selective Serotonin Reuptake Inhibitors on Sleep Architecture of Depressive Patients and Its Relationship with the Clinical Effect
下载PDF
导出
摘要 目的探究选择性5-羟色胺再摄取抑制剂(SSRIs)对抑郁症患者睡眠结构的影响及与临床疗效的关系。方法从多导睡眠图(PSG)数据库选择了26例接受SSRIs治疗2周以上的抑郁症患者(治疗组),并同时选择了24例近3个月未接受药物治疗的抑郁症患者(未治疗组)。评估患者睡眠情况,采用汉密尔顿抑郁量表24项版本(HAMD-24)评估患者治疗前后的抑郁状况,采用Logistic回归分析抑郁症患者睡眠结构变化与临床疗效的关系。结果治疗组和未治疗组的睡眠长度、睡眠潜伏期、非快速动眼时相睡眠(NREM)Ⅱ期与Ⅲ期的睡眠比例差异均无统计学意义(P>0.05)。经过SSRIs治疗,治疗组进入快速动眼时相(REM)的时间与未治疗组相比缩短〔(77±30)min vs.(146±64)min〕,差异有统计学意义(P=0.000),并进入正常范围;治疗组的NREMⅠ期睡眠比例与治疗组相比〔(14±5)%vs.(18±8)%〕和微觉醒指数(AI)〔(14±5)次/h vs.(18±6)次/h〕均减少,但AI仍高于正常值(<5次/h),差异均有统计学意义(P<0.05)。治疗组与未治疗组HAMD-24得分间差异有统计学意义〔(17±6)分vs.(27±10)分,P=0.007〕。Logistic回归显示治疗组患者的REML越短〔OR=0.627,95%CI(0.517,0.923)〕和AI越低〔OR=0.839,95%CI(0.721,0.987)〕,就越容易显示出临床疗效。结论抑郁症的REM睡眠异常应该是抑郁症的核心睡眠节律异常,支持了抑郁症的睡眠时相前移假说;睡眠结构的改变影响临床疗效。 Objective To investigate the influence of selective serotonin reuptake inhibitors(SSRIs) on sleep architecture of depressive patients and the relationship between the sleep architecture and the clinical effect of SSRIs. Methods Totally 26 depressive patients with SSRIs treated in recent 2 weeks were recruited as treatment group from the polysomnography database,and 24 age-and sex-matched depressive patients without medication in recent 3 months as un-treatment group were recruited at the same time.The Hamilton Rating Scale for Depression-24 items(HAMD-24) was used for assess the depression conditions before and after the treatment,and Logistic regression analysis was taken to determine the relationship between the sleep architecture and the clinical effect. Results There were no statistically significant differences between the two groups in sleep duration,sleep latency,percentages of stage II and III sleep(P0.05).After SSRIs treatment,the latency of rapid eye movement(REM) in the treatment group was shortened as compared with the non-treatment group((77±30) min vs.(146±64) min)(P=0.000) and reached into normal range,and percentage of stage I sleep((14±5)% vs.(18±8) %)and arousal index(AI)((14±5)times/h vs.(18±6)times/h) decreased(P0.05),but the AI still was higher than normal(5 times/h).The difference in HAMD-24 score between the two groups was statistically significant((17±6) vs.(27±10),P=0.007).Logistic regression showed that the clinical effect was associated with shorten REM latency(OR=0.627,95%CI(0.517,0.923)) and decreased AI(OR=0.839,95%CI(0.721,0.987)). Conclusion The abnormal REM sleep may be the core of abnormal sleep rhythm in depressive disorder,which supports the hypothesis of advanced sleep phase.
出处 《中国全科医学》 CAS CSCD 北大核心 2013年第1期55-58,共4页 Chinese General Practice
基金 广东省科技厅科技计划引导项目(2010B031600154) 广州市属高校科技计划项目(08A036)
关键词 选择性5-羟色胺再摄取抑制剂 睡眠结构 抑郁症 临床疗效 Selective serotonin reuptake inhibitor Sleep architecture Depression Clinical effect
  • 相关文献

参考文献23

  • 1Billard M. Sleep:Physiology,investigation and medicine[M].New York:Kluwer Academic/Plenum Publisher,2003.
  • 2Reynolds CF III,Kupfer DJ. Sleep research in affective illness[J].Journal SLEEP,1987,(03):199-215.
  • 3Rush AJ,Giles DE,Jarrett RJ. Reduced REM latency predicts response to tricyclic medication in depressed outpatients[J].Biological Psychiatry,1989,(01):61-72.
  • 4Arieti S. American handbook of psychiatry Vol 7[M].New York:Basic Books Inc,1981.46-74.
  • 5Thase ME,Fasiczka AL,Berman SR. Electroencephalographic sleep profiles before and after cognitive behavior therapy of depression[J].Archives of General Psychiatry,1998,(02):138-144.doi:10.1001/archpsyc.55.2.138.
  • 6White KJ,Walline CC,Barker EL. Serotonin transporters:Implications for antidepressant drug development[J].AAPS JOURNAL,2005,(02):421-433.
  • 7Goldstein BJ,Goodnick PJ. Selective serotonin reuptake inhibitors in the treatment of affective disorders,3:Tolerability,safety,and pharmacoeconomics[J].Journal of Psychopharmacology,1998,(Suppl B):55-87.
  • 8Dorsey CM,Lukas SE,Cunningham SL. Fluoxetine-induced sleep disturbance in depressed patients[J].Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology,1996,(06):437-442.
  • 9Feige B,Voderholzer U,Riemann D. Fluoxetine and sleep EEG:Effects of a single dose,subchronic treatment,and discontinuation in healthy subjects[J].Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology,2002,(02):246-258.
  • 10Shen J,Shapiro C. Polysomnographic sleep effects of fluoxetine and nefazodone on a seasonal affective disorder patient[J].Sleep Medicine,2002,(06):527-528.

同被引文献251

引证文献24

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部