【摘要】：目的：研究晝夜生物節(jié)律(CR)和睡眠模式特征在雙相障礙（BD）緩解期患者與正常對(duì)照者中的不同特征，探討晝夜生物節(jié)律與睡眠模式是否為雙相障礙緩解期特征性指標(biāo)。 方法：通過(guò)嚴(yán)格的結(jié)構(gòu)化臨床會(huì)晤，根據(jù)《精神障礙診斷與統(tǒng)計(jì)手冊(cè)（第四版）》（DSM-IV）中關(guān)于雙相障礙Ⅰ型的診斷標(biāo)準(zhǔn)，篩選BD患者20例和年齡、性別匹配對(duì)照者20例，采用漢密爾頓抑郁量表（HAMD）、Bech-Rafaelsen躁狂量表（BRMS）、狀態(tài)-特質(zhì)焦慮量表（STAI）、匹茲堡睡眠質(zhì)量指數(shù)問(wèn)卷（PSQI）、篩查所有受試者的情緒、睡眠狀況，并進(jìn)行連續(xù)1周Actigraph體動(dòng)監(jiān)測(cè)，使用ActiLife5.6.4軟件分析受試者活動(dòng)量、活動(dòng)節(jié)律以及睡眠狀況。采用SPSS16.0統(tǒng)計(jì)分析軟件對(duì)研究數(shù)據(jù)進(jìn)行分析。 結(jié)果：1、病例組與對(duì)照組每天單位體重活動(dòng)耗能（kcal/kg）（3.325±1.193v.s.4.243±0.7611，p=0.001）、活動(dòng)分級(jí)比例（%）（靜坐級(jí)：77.71±6.99v.s.69.99±6.71，p=0.001；輕度級(jí)：2.69±2.02v.s.7.84±3.35，p=0.000；中度級(jí)：0.02±0.03v.s.0.68±0.99，p=0.004）存顯著性差異。2、病例組與對(duì)照組工作日和周末活動(dòng)量分級(jí)自身比較不具統(tǒng)計(jì)學(xué)差異。3、病例組與對(duì)照組日間穩(wěn)定性（IS）比較不具統(tǒng)計(jì)學(xué)差異（p=0.06）；晝夜變異性（IV）比較具有統(tǒng)計(jì)學(xué)差異（p=0.002）。4、病例組和對(duì)照組睡眠參數(shù)比較不具有統(tǒng)計(jì)學(xué)差異，對(duì)照組中周末比工作日總睡眠時(shí)間長(zhǎng)（p=0.004）。 結(jié)論：雙相障礙緩解期患者仍然具有明顯的活動(dòng)量、活動(dòng)節(jié)律的改變。提示雙相障礙緩解期患者仍然具有生物節(jié)律的紊亂。生物節(jié)律變化獨(dú)立雙相障礙的其他癥狀，，可能是雙相障礙病程中病情緩解復(fù)發(fā)的有效生物學(xué)指標(biāo)。
[Abstract]:Aim: to study the different characteristics of circadian biological rhythm (CR) and sleep pattern in patients with bipolar disorder (BD) in remission period and in normal controls, and to explore whether circadian biological rhythm and sleep pattern are characteristic indexes of bipolar disorder remission. Methods: 20 patients with BD and 20 matched controls with age and sex were selected according to the criteria of bipolar disorder type I in the Diagnostic and Statistical Manual for Mental Disorder (fourth Edition) (DSM-IV). The Hamilton Depression scale (HAMD), Bech-Rafaelsen), the (BRMS), mania scale (BRMS), the Pittsburgh Sleep quality Index (STAI),) and the Pittsburgh Sleep quality Index (PSQI),) were used to screen the mood and sleep status of all subjects. The body movement of Actigraph was monitored for 1 week, and the activity, rhythm and sleep status of subjects were analyzed by ActiLife5.6.4 software. SPSS16.0 statistical analysis software was used to analyze the research data. Results: 1. The activity energy consumption (kcal/kg) per unit body weight was (3.325 鹵1.193v.s.4.243 鹵0.7611) per day and the activity grading ratio (%) in the case group and the control group was 77.71 鹵6.99v.s.69.99 鹵6.71, respectively. P0. 001; Mild grade: 2.69 鹵2.02v.s.7.84 鹵3.35 p0. 000; Moderate grade: 0.02 鹵0.03v.s.0.68 鹵0.99p 0.004). 2There was no significant difference in the activity levels between the case group and the control group on weekdays and weekends. There was no significant difference in day stability (IS) between the case group and the control group (p0. 06). The diurnal variability of (IV) was statistically different (p0. 002). 4. There was no significant difference in sleep parameters between the case group and the control group, and the total sleep time in the control group was longer than that in the working day (p0. 004). Conclusion: the patients with bipolar disorder still have significant changes in activity volume and activity rhythm. The results suggest that the patients with bipolar disorder still have the disorder of biological rhythm. Other symptoms of biphasic disorder may be an effective biological index for remission and recurrence of biphasic disorder in the course of bipolar disorder.
【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R749.4

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