摘要
目的比较持续正压通气(continuous positive airway pressure,CPAP)治疗前后原发性中枢性睡眠呼吸暂停综合征(central sleep apnea syndrome,CSAS)患者睡眠脑电图(electroencephalogram,EEG)的变化,从EEG变化的角度探讨CPAP改善CSAS患者脑功能的机制。方法回顾性分析本院经多导睡眠监测诊断为原发性CSAS、并于多导睡眠监测下行CPAP压力滴定的6例原发性CSAS患者的临床资料,采用分型维数(fractal dimension,FD)和过零率(zero-crossing rate of detrended FD,z DFD)对脑电原始信号进行提取和分析,比较CPAP治疗前后CSAS患者睡眠脑电的FD和z DFD变化。结果 CPAP治疗后,原发性CSAS患者睡眠呼吸暂停低通气指数显著降低(P<0.05),非快速眼动(non-rapid eye movements,NREM)睡眠期FD显著降低(P<0.05),快速眼动(rapid eye movements,REM)睡眠期FD显著升高(P<0.05);而z DFD在NREM睡眠期和REM睡眠期均无显著变化(P_均>0.05)。结论 CPAP可以降低CSAS患者NREM睡眠期脑电的复杂度,提高REM睡眠期脑电的复杂度,这可能是CPAP改善CSAS患者脑功能的机制之一。
ObjectiveCompare the changes of sleep electroencephalogram in patients with primary central sleep apnea syndrome （CSAS） before and after continuous positive airway pressure （CPAP） treatment, and explore the mechanism and effcacy of continuous positive airway pressure from the perspective of sleep electroencephalogram （EEG）. MethodSix patients with primary CSAS diagnosed by polysomnography （PSG） and given CPAP pressure titration under PSG monitoring were retrospectively analyzed. The fractal dimension （FD） and zero-crossing rate of detrended FD （zDFD） was used to extract and analyze the original EEG signals. The changes of sleep EEG FD and zDFD in CSAS patients before and after CPAP treatment were analyzed. ResultAfter CPAP treatment, the apnea-hypopnea index of the patients with primary CSAS decreased signiffcantly. Non-rapid eye movements （NREM） sleep period FD decreased signiffcantly （P〈0.05）, rapid eye movements （REM） sleep period FD increased signiffcantly （P 〈0.05）. However, zDFD didn＇t change signiffcantly during NREM and REM sleep period （Pall〉 0.05）. ConclusionCPAP can reduce the complexity of sleep EEG in NREM sleep period and increase the complexity of sleep EEG in REM sleep period, which may be one of the mechanisms of CPAP improving brain function in CSAS patients.
作者
张成
马靖
陈坤
陈雪
王广发
张珏
ZHANG Cheng;MA Jing;CHEN Kun;CHEN Xue;WANG Guang-fa;ZHANG Yu(Department of Respiratory and Critical Care Medicine,Peking Universtiy,First Hospital,Beijing 100034,China;Academy for Advanced Interdisciplinary Studies,Peking Universtiy,Beijing 100871,China)
出处
《中国医学前沿杂志（电子版）》
2018年第9期75-79,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
原发性中枢性睡眠呼吸暂停综合征
睡眠脑电图
持续正压通气
分型维数
Primary central sleep apnea syndrome
Sleep electroencephalogram
Continuous positive airway pressure
Fractal dimension
