本文選題：癲癇　切入點(diǎn)：發(fā)作時(shí)間　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:比較一天中不同時(shí)間發(fā)作的癲癇患者睡眠結(jié)構(gòu)的特征。方法:選取2016年3月至2017年1月就診于山西醫(yī)科大學(xué)第一臨床醫(yī)學(xué)院神經(jīng)內(nèi)科的88例癲癇患者,根據(jù)癲癇發(fā)作時(shí)間的不同將癲癇患者分為3組:夜間發(fā)作組(僅在夜間發(fā)作的癲癇患者30例)、白天發(fā)作組(僅在白天發(fā)作的癲癇患者30例)、以及混合發(fā)作組(白天和夜間都有發(fā)作的癲癇患者28例)。同時(shí),在體檢部門(mén)采集80例健康人為對(duì)照組。各組研究對(duì)象均于我院神經(jīng)內(nèi)科腦電圖室行多導(dǎo)睡眠監(jiān)測(cè)(Polysomnography,PSG)。通過(guò)獲得的多導(dǎo)睡眠圖分析不同研究對(duì)象的睡眠結(jié)構(gòu),首先比較癲癇患者組與健康對(duì)照組睡眠結(jié)構(gòu)的不同,再進(jìn)一步比較三組癲癇患者的睡眠特征。結(jié)果:1.癲癇組和健康對(duì)照組比較:總睡眠時(shí)間明顯縮短(P0.05),睡眠效率顯著下降(P0.05),睡眠潛伏期、REM潛伏期均延長(zhǎng)(均P0.05),NREM1、2期和清醒期明顯延長(zhǎng)(均P0.05),NREM3+4期、REM期明顯縮短(P0.05)。2.夜間發(fā)作組與白天發(fā)作組比較:總睡眠時(shí)間明顯減少(P0.05),睡眠效率顯著降低(P0.05),NREM1期、2期及清醒期明顯延長(zhǎng)(均P0.05),NREM3+4期、REM期明顯縮短(P0.05),睡眠潛伏期與REM潛伏期延長(zhǎng)(P0.05)。3.夜間發(fā)作組與混合發(fā)作組相比:睡眠潛伏期與REM潛伏期明顯延長(zhǎng)(P0.05),NREM1、2期及清醒期顯著延長(zhǎng)(P0.05),而總睡眠時(shí)間明顯減少(P0.05)、睡眠效率顯著(P0.05)降低,NREM3+4期與REM期縮短(P0.05)。4.混合發(fā)作組與白天發(fā)作組比較:總睡眠時(shí)間明顯縮短(P0.05),睡眠效率顯著下降(P0.05),NREM1、2期與清醒期延長(zhǎng)(P0.05),NREM3+4期與REM期減少(P0.05),而睡眠潛伏期與REM潛伏期明顯延長(zhǎng)(P0.05)。結(jié)論:1.癲癇組與健康對(duì)照組比較,睡眠結(jié)構(gòu)有明顯差異;2.夜間發(fā)作組、白天發(fā)作組、混合發(fā)作組三組相互比較,睡眠結(jié)構(gòu)均有顯著性差異,其中夜間發(fā)作組的睡眠結(jié)構(gòu)變化更大。
[Abstract]:Objective: to compare the sleep structure of epileptic patients with seizures at different times of day. Methods: from March 2016 to January 2017, 88 patients with epilepsy were enrolled in the Department of Neurology, the first Clinical Medical College of Shanxi Medical University. Epileptic patients were divided into three groups according to the time of seizure: nocturnal seizure group (30 epileptic patients with nocturnal seizure only, daytime seizure group (30 epileptic patients only during daytime attack), and mixed seizure group (white). There are 28 epileptic patients with seizures both at night and in the sky. At the same time, 80 healthy persons were collected in the physical examination department as control group. The subjects in each group were monitored by polysomnography PSGG in electroencephalogram room of neurology department of our hospital. The sleep structure of different subjects was analyzed by polysomnography. First of all, the differences in sleep structure between the epileptic group and the healthy control group were compared. The sleep characteristics of epileptic patients in the three groups were further compared. Results 1. Comparison between the epilepsy group and the healthy control group: the total sleep time was significantly shorter than that in the healthy control group: the total sleep time was significantly shortened, the sleep efficiency was significantly decreased, and the REM latency of sleep latency was prolonged (all P 0.05). The waking period was significantly prolonged (P0.05 / NREM34 / REM phase was significantly shorter than that in the daytime group). Compared with the daytime group, the total sleep time was significantly reduced, the sleep efficiency was significantly decreased, the sleep efficiency was significantly decreased, and the waking stage was significantly prolonged (P0.05 / NREM34 / REM / REM / REM / NREM34 / REM / REM). Compared with the mixed attack group, the sleep latency and REM latency of the nocturnal attack group were significantly longer than that of the mixed attack group. The sleep latency and the REM latency were significantly prolonged in the second stage and the waking stage, while the total sleep time was significantly reduced, and the sleep effect was significantly decreased in the nocturnal attack group than in the mixed attack group. Compared with the daytime attack group, the total sleep time was significantly shorter than that in the daytime attack group, and the sleep efficiency was significantly decreased P0.05NREM1 / 2 and prolonged P0.05NREM34 and REM, while the sleep latency was decreased in P0.05NREM34 and REM. The latent period of REM was prolonged significantly (P 0.05). Conclusion: 1. Compared with the healthy control group, the epileptic group, the epileptic group and the healthy control group, There were significant differences in sleep structure among the three groups: nocturnal attack group, daytime attack group and mixed attack group. There were significant differences in sleep structure among the three groups, among which the sleep structure of nocturnal attack group changed more than that of nocturnal attack group.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R742.1

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