不同病因白天过度嗜睡患者嗜睡相关因素研究

目的 探讨不同病因的白天过度嗜睡患者嗜睡相关因素,为临床诊断治疗及行为指导提供帮助.方法 病例按诊断分为特发性过度睡眠组(A组,n =21)、阻塞性睡眠呼吸暂停综合症组(B组,n =13)、发作性睡病组(C组,n =15),均采用匹兹堡睡眠质量指数量表(PSQI)和Epworth嗜睡程度量表(ESS)进行睡眠质量和嗜睡程度评定,采用多次小睡潜伏期试验(MSLT)进行实验室检查.结果 3组患者PSQI总分、睡眠质量、睡眠障碍两因子分B组[(7.85±1.72)分,(1.77±1.01)分,(2.38±0.65)分]均高于A组与C组,差异有极显著性( F =18.37 11.21 25.67,P ＜0.01),而C组显著高于A组( P ＜0.05).ESS评分3组间比较B组[(14.31±3.98)分]显著高于A组与C组,均差异有极显著性( F =5.67,P ＜0.01);且A组与C组ESS总分均＞6分,而B组＞11分,MSLT测试各因子均差异有极显著性(均P ＜0.01).两两比较睡眠发作次数C组高于A、B组( P ＜0.05或0.01),B组高于A组( P ＜0.01);睡眠潜伏期C组短于A、B组( P ＜0.05或0.01),且B组短于A组( P ＜0.01);快眼动睡眠次数C组高于A、B组( P ＜0.01),快眼动睡眠潜伏期较A、B组显著缩短( P ＜0.01).结论 不同原因的EDS患者其睡眠质量、嗜睡程度、MLST各有特征,对患者采用PSQI、ESS评定和MSLT测试综合评价,有助于临床诊断、治疗及行为指导.

A study of drowsiness related factors of patients with excessive daytime drowsiness due to different causes

Objective To explore drowsiness correlation factors of patients with excessive daytime drowsiness(EDD) due to different causes,and to provide helps for clinical diagnosis and treatment as well as behavior guidance. Methods Cases were divided into idiopathic hypersomnia(group A,n =21), obstructive sleep apnea syndrome(group B,n =13) and narcolepsy group(group C,n =15) according to their diagnoses.Sleep quality and drowsiness degree were assessed with the Pittsburgh Sleep Quality Index(PSQI), and the Epworth Sleepiness Scale(ESS) and laboratory examinations conducted using multiple sleep latency test(MSLT). Results The PSQI total, sleep quality and somnipathy scores were all higher in group B(7.85±1.72 1.77±1.01 2.38±0.65) than in both group A and group C,and differences very significant by analyses of variance( F =18.37 11.21 25.67,P ＜0.01),but those significantly higher in group C than in group A( P ＜0.05 or 0.01).The ESS score was significantly higher in group B(14.31±3.98) than in group A and group C, differences were significant( F =5.67,P ＜0.01);the ESS total scores of both group A and group C were >6 and that of group B >11 ,there were very significant differences among all factors according to the MSLT(all P ＜0.01).Two-two comparisons showed that narcolepsy frequencies were higher in the group C than in group A and B ( P ＜0.05 or 0.01) and in group B than in group A( P ＜0.01); sleep latency was shorter in the group C than in group A and group B( P ＜0.05 or 0.01) and in the B than in group A ( P ＜0.01); REM frequencies were more( P ＜0.05 or 0.01) and REM sleep latencies significantly shorter( P ＜0.01) in group C than in group A and group B.Conclusion EDS patients with different causes have characteristic sleep quality, drowsiness and MLST,and comprehensive evaluations of PSQI,ESS and MSLT on patients make for clinical diagnose,treatment and behavior guidance.