本文選題：肌萎縮側(cè)索硬化　切入點：多導(dǎo)睡眠圖　出處：《南昌大學(xué)》2014年碩士論文

【摘要】：目的：探討肌萎縮側(cè)索硬化（ALS）患者夜間睡眠進程和睡眠結(jié)構(gòu)的改變及其相關(guān)因素。 方法：應(yīng)用多導(dǎo)睡眠圖（PSG），對40例ALS患者（研究組）和40例健康體檢者（對照組）進行夜間睡眠進程和睡眠結(jié)構(gòu)檢測，比較兩組相關(guān)檢測指標(biāo)的差異，并進行ALS患者睡眠進程和睡眠結(jié)構(gòu)改變的相關(guān)因素分析。 結(jié)果：（1）研究組與對照組相比，總睡眠時間（TST）明顯縮短（P＜0.001），睡眠效率（SE）明顯降低（P＜0.001），覺醒期（WASO）明顯延長（P＜0.001）；睡眠潛伏期（SL）和覺醒次數(shù)（AT）有延長、增加趨勢，但不顯著（P＞0.05）。（2）研究組和對照組相比，S2期睡眠、S3期睡眠及快速眼動期（REM）睡眠均明顯縮短（分別P＜0.001、P＜0.001、P＜0.05）；S1期睡眠延長不顯著（P＞0.05）。（3）研究組睡眠進程改變的相關(guān)因素分析顯示，患者年齡與TST呈負相關(guān)（r＝-0.312，P＝0.05），患者最低血氧飽和度（SpO2）與TST呈正相關(guān)（r＝0.328，P＜0.05），患者體重指數(shù)（BMI）、病程長短、綜合醫(yī)院抑郁量表（HADSd）評分、綜合醫(yī)院焦慮量表（HADSa）評分、改良肌萎縮側(cè)索硬化功能量表（ALSFRS-R）評分、睡眠呼吸暫停/低通氣指數(shù)（AHI）和平均SpO2與TST均無直線相關(guān)（P＞0.05）；上述相關(guān)因素與患者SL、SE、AT均無直線相關(guān)（P＞0.05）；患者年齡與WASO呈正相關(guān)（r＝0.335，P＜0.05），其余相關(guān)因素與WASO無直線相關(guān)（P＞0.05）。（4）研究組睡眠結(jié)構(gòu)改變的相關(guān)因素分析顯示，患者病程長短與S2期睡眠呈負相關(guān)（r＝-0.337，，P＜0.05），患者ALSFRS-R評分和最低SpO2與S2期睡眠呈正相關(guān)（分別r＝0.319，P＜0.05和r＝0.338，P＜0.05），患者年齡、BMI、HADSd評分、HADSa評分、AHI、平均SpO2與S2期睡眠無直線相關(guān)（P＞0.05）；患者年齡與REM期睡眠呈負相關(guān)（r＝-0.549，P＜0.05），其余相關(guān)因素與REM期睡眠無直線相關(guān)（P＞0.05）；上述相關(guān)因素與S1期睡眠和S3期睡眠均無直線相關(guān)（P＞0.05）。 結(jié)論：ALS患者存在明顯睡眠進程和睡眠結(jié)構(gòu)的改變，患者年齡、病程長短、病情程度和最低SpO2等可能是主要相關(guān)因素。PSG應(yīng)作為ALS患者常規(guī)評估手段。
[Abstract]:Objective: to investigate the changes and related factors of sleep process and sleep structure in patients with amyotrophic lateral sclerosis (ALS). Methods: 40 patients with ALS (study group) and 40 healthy controls (control group) were tested for sleep progression and sleep structure by using polysomnography (PSG), and the differences between the two groups were compared. The related factors of sleep process and sleep structure changes in patients with ALS were analyzed. Results compared with the control group, the total sleep time (TST) of the study group was significantly shorter than that of the control group (P < 0.001), the sleep efficiency was significantly decreased (P < 0.001), the wakefulness phase was significantly prolonged (P < 0.001), the sleep latency (SLT) and the number of awakenings (ATT) were increased. But there was no significant difference between the study group and the control group (P > 0.05, P > 0.05, P > 0.05, P > 0.05). Compared with the control group, the sleep duration of the study group was significantly shorter than that of the control group (P < 0.001, P < 0.001, P < 0.001, P < 0.05, P > 0.05, P > 0.05, P > 0.05, respectively). There was a negative correlation between age and TST, and there was a positive correlation between the minimum oxygen saturation (SPO _ 2) and TST (P < 0.05), body mass index (BMI), duration of disease, general hospital depression scale (HADSdD), and general hospital anxiety scale (HADSa). Modified amyotrophic lateral sclerosis scale (ALSFRS-R) score; Sleep apnea / hypopnea index (AHII) and average SpO2 had no linear correlation with TST (P > 0.05); there was no linear correlation (P > 0.05); age was positively correlated with WASO 0.335 (P < 0.05); other related factors had no linear correlation with WASO (P > 0.05). Analysis of the related factors of sleep structure changes in group A showed that, There was a negative correlation between duration of disease and sleep in S2 stage (P < 0.05). The ALSFRS-R score and minimum SpO2 were positively correlated with sleep in S2 stage (r = 0.319, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, respectively). There was no linear correlation between average SpO2 and sleep in S2 stage (P > 0. 05), and there was no linear correlation between age and age (P > 0. 05). There was a negative correlation between REM sleep and REM sleep (P < 0.05), but there was no linear correlation between the other factors and REM sleep (P > 0.05), but there was no linear correlation between the above factors and S1 stage sleep and S3 stage sleep (P > 0.05). Conclusion there are significant changes in sleep process and sleep structure in patients with ALS. Age, duration of disease, severity of disease and minimum SpO2 may be the main related factors. PSG should be used as a routine evaluation method for ALS patients.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R744.8

【參考文獻】

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1 張景行;;睡眠障礙國際分類第2版內(nèi)容簡介[J];中國新藥與臨床雜志;2007年10期

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