癫患儿睡眠结构与认知行为关系的研究

Study of relation between sleep architecture and cognitive behavior in children with epilepsy

目的探讨特发性癫患儿睡眠结构改变与认知行为异常的关系。方法对64例特发性癫患儿(癫疒间组)进行全夜睡眠多导监测、日间注意力测定及Achenbach儿童行为量表评估情感行为状态;应用秩相关系数分析睡眠与注意力、行为的相关性,并与20名正常儿童(正常对照组)进行比较。结果与正常对照组相比,癫疒间组睡眠Ⅰ期百分比和快速眼动期(REM)潜伏期显著延长(均P<0.05);部分性发作患儿入睡后觉醒次数较全身性发作患儿显著增多(P<0.05);应用丙戊酸钠的患儿睡眠总记录时间较未服用抗疒间药者延长(P<0.05);记录到疒间性电发放的患儿睡眠总记录时间、REM潜伏期延长,睡眠效率降低(均P<0.05);癫疒间组患儿划消试验总参数较正常对照组明显升高(P<0.05);Achenbach儿童行为量表总体行为问题评分升高(P<0.05),秩相关分析示划消试验总参数与睡眠Ⅰ期百分比成正相关(r=0.68,P<0.05),儿童行为量表评分与REM百分比呈正相关(r=0.57,P<0.05)。结论特发性癫疒间患儿睡眠结构异常,其与患儿的日间注意力及行为异常有关。

Objective To observe the relations of sleep structure changes and cognitive behavior abnormalities in children with idiopathic epilepsy. Methods All night polysomnographies, day attention test and Aehenbach child behavior checklist were done on 64 children with idiopathic epilepsy and 20 healthy controls the requirement. Spearman correlations were made to evaluate the correlations between the parameters of sleep structure and the results of attention and cognitive behavior abnormalities. Results All children with epilepsy had longer stage I sleep percentage and latency of rapid eye movement （ REM ） sleep compared with controls （ all P〈0.05 ）. Children with partial epilepsy had more wakefulness after sleep onset compared with children with generalized epilepsy （ P〈0.05 ）. Those patients with administration valproate sodium had longer total recording time than those without taking Valproate sodium （P〈0.05） . Patients who recorded the epileptic discharges had longer total recording time and REM latency, lower sleep efficiency （all P〈0.05 ）. The symbols cancellation test overall index and child behavior checklist problem score were higher than those of controls （ all P〈0.05）. The analysis of rank correlation coefficient showed symbols cancellation test overall index had positive correlation with stage Ⅰ sleep percentage （r=0. 68 ,P〈0. 05 ）, total problem score had positive correlation with REM percentage （r=0. 57, P〈 0. 05 ）. Conclusions Sleep architecture in children with idiopathic epilepsy is abnormal which are related with daytime attention and behavioral abnormalities.