摘要
目的 探讨阿尔茨海默病 (Alzheimer’sdisease ,AD)患者清醒和睡眠状态电生理活动的变化。方法 对 16例临床诊断的AD患者及 16名年龄匹配的健康人进行对照研究。所有受试者均进行连续两次的全夜多导睡眠生理录像监测。共用 2 1个导联分别记录脑电图、眼动图、下颌肌电图、心电图以及经鼻气流。结果 (1)AD组睡眠结构紊乱 ,其中总睡眠时间 (F =6 30 ,P =0 0 179)、Ⅱ期睡眠时间 (F =16 0 3,P =0 0 0 0 4 )、快速眼动 (rapideyemovement,REM)睡眠时间 (F =9 84 ,P =0 0 0 2 1)均明显减少 ,而慢波睡眠成分增多 (F =11 5 0 ,P =0 0 0 4 )。 (2 )Ⅱ期睡眠中睡眠纺锤的时限、密度、相对功率、绝对功率以及K综合密度 (F =13 6 4～ 79 11,P <0 0 0 0 1) ,REM睡眠 8～ 13Hz快活动 (F =5 80～ 2 0 73,P <0 0 5 )较对照组明显减少。 (3)多因素回归分析显示 ,睡眠纺锤密度、波幅以及K综合密度的改变与精神行为异常关系最密切。结论 AD组睡眠结构明显紊乱 ,并伴有多项睡眠脑电成分的异常。与清醒和REM睡眠相比 ,睡眠纺锤的改变与患者精神行为异常的关系更加密切 ,可能具有更高的诊断敏感性。
Objective To determine whether sleep structures,the waveform components of NREM and rapid eye movement (REM) sleep, and the relationship between sleep variables and mental status are altered. Methods Totally 16 Alzheimer's disease(AD) patients and 16 age-matched controls were studied for two consecutive nights.All cases were video-monitored during the recordings of electroencephalography,electro-oculography,electrocardiography,electromyography in chin,and nasal airflow. Results (1) Compared with normal controls,duration of total sleep ( F =6.30, P =0.017 9),stage Ⅱ sleep ( F =16.03, P =0.000 4),and REM sleep ( F =9.84, P =0.002 1) were remarkably decreased,but waveform components of slow-wave (stage Ⅲ-IV) sleep ( F =11.50, P =0.004) were increased in AD patients.(2) Sleep spindle duration and density,and its relative and absolute power,and K complex density ( F =13.64～79.11, P <0.000 1) in stage Ⅱ sleep,and fast activities of REM sleep ( F =5.80～20.73, P <0.05) were significantly decreased.In wakeful EEG,α power was decreased ( F =18.05～34.48, P <0.01),but δ power increased ( F = 10.00～21.43, P <0.01).(3) In AD patients,there were significant correlations between sleep structure disorganization and waveform component changes of sleep EEG and the clinical abnormalities ( r =0.51～0.93,or r =-0.93～-0.51, P <0.05).Multiple regression analysis showed that changes of sleep spindle density and amplitude and K complex density were the most significant factors in correlation with clinical findings in the AD patients.Conclusions In AD patients,disorganization of sleep structures and abnormalities of sleep spindle and K complexes and REM sleep were demonstrated in the polysomnography studies.The changes of sleep spindle in stage Ⅱ sleep had closer correlation with clinical changes than those of REM sleep or alpha activities in wakening state.Sleep spindle was shown to be more sensitive to the diagnosis of AD.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2003年第3期210-213,共4页
Chinese Journal of Neurology
