阻滞性与非阻滞性抑郁症患者睡眠脑电图研究

目的 探讨阻滞性和非阻滞性抑郁症患者多导睡眠图(polysomnography,PSG)的特点.方法 将符合中国精神障碍分类与诊断标准第3版(CCMD-3)中单相抑郁症的诊断标准,且1月内未服用药物的28名抑郁症患者按汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)阻滞因子得分,分为阻滞组(n=14)和非阻滞组(n=14),并与15名正常对照组进行对照.3组均进行PSG测定.结果 与对照组相比,阻滞组和非阻滞组睡眠总时间、睡眠效率下降(t=-2.32,-2.17;t=-2.34,-2.16),睡眠潜伏期延长(t=2.87,2.93),觉醒时间、觉醒次数、觉睡比增加(t=2.97,2.84,3.02;t=2.85,2.80,2.98),S1百分比、快眼动睡眠(REM)百分比均增加(t=2.23,2.16;t=2.19,2.08),慢波睡眠比例降低(t=-2.44,-2.36),REM睡眠时间、睡眠潜伏期缩短(t=-2.21,-2.56;t=-2.52,-2.48),REM活动度、强度增加(t=2.73,2.76;t=2.28,2.55),均差异有统计学意义(均P＜0.05或0.01).阻滞组REM密度(170±24.8)μ/min]高于非阻滞组(145±21.8)μ/min]和对照组(122±19.4)μ/min,t=2.36,2.75,P＜0.05).结论 阻滞性和非阻滞性抑郁症PSG都呈现出异常表现,阻滞症状越突出,REM密度可能越高.阻滞性与非阻滞性抑郁症之间PSG并未表现出显著差异.

Study on the polysomnography of the patients with depression

Objective To investigate the variations of polysomnography of the patients with retardative depression and non-retardative depression. Methods Twenty-eight patients with depression without any medicine at least for 1 month and fifteen normal controls were assessed in this study. Based on the scores of retardation of Hamilton Depression Scale( HAMD), the patients were divided into the group of retardative depression and the group of non-retardative depression. Polysomnography was given to all the subjects. Results Compared with the normal controls, the depressive patients both in the retardative depression group and in the non-retardative depression group showed significant differences of lower total sleep time (TST), sleep efficiency (SE), SWS% , rapid eye movement ) sleep time ( RT), REM sleep latency (RL) ( all P ＜ 0. 05 ), and higher sleep latency (SL) , awakening time( AT), awakening number( AN ), the percentage of AT( A/TST% ), the percentage of 1 sleep( S1 % ), the percentage of RT( RT% ), REM activity ( RA), and REM intensity (RI). REM density (RD) in the retardative depression group was significantly higher than both the non-retardative depression group and the control group ( t =2.36, P＜ 0. 05; t = 2.75, P＜ 0. 05 ). Conclusion Abnormalities of PSG in depression are proved, and RD may be relative to retardation. The differences of PSG do not existed between different kinds of depression such as retardative depression and non-retardative depression.