曲唑酮治疗抑郁症睡眠障碍病人多导睡眠图变化

Study on effects and varieties of polysomnography in insomnia patients with depression cared with trazodone

目的:探讨抑郁症合并睡眠障碍病人多导睡眠图特点,并与正常人比较,探讨曲唑酮治疗效果及多导睡眠图(PSG)变化。方法:应用Polysmith型多导睡眠图,对21名抑郁症合并睡眠障碍病人及10名正常对照者进行测定,抑郁症病人曲唑酮治疗2mo后复查多导睡眠图,并进行治疗前后抑郁自评量表、汉密尔顿焦虑量表测定。测量数据以(?)±s表示,统计方法采用SPSS 11.0进行分析。结果:与正常对照者比较,抑郁症合并睡眠障碍病人觉醒时间、快动眼(REM)睡眠、S2显著延长,总睡眠时间、睡眠效率、REM睡眠潜伏期、慢波(S3+S4)睡眠明显缩短。抑郁症组曲唑酮治疗后PSG显示总睡眠时间延长[治疗前(350±s 30)min,治疗后(393±27)min,P<0.01],睡眠效率增加[治疗前(74.0±2.0)%,治疗后(86±4)%,P<0.05],觉醒时间缩短[治疗前(82±7)min,治疗后(19±5)min,P<0.01],REM睡眠缩短[治疗前(107±13)min,治疗后(98±7)min,P<0.01],S2缩短[治疗前(189±5) min,治疗后(181±4)min,P<0.05],慢波睡眠延长[治疗前(40±3)min,治疗后(69.0±2.0) min,P<0.01]。睡眠潜伏期、REM睡眠潜伏期、REM睡眠次数、S1未见明显变化(P>0.05)。抑郁自评量表和汉密尔顿焦虑量表评分改善。结论:抑郁症合并睡眠障碍病人PSG指标异常,曲唑酮治疗后睡眠好转,精神量表及PSG异常指标有改善。

AIM： To explore the characteristic of changes of polysomnography （PSG） between insomniapatients with depression and normal people. To assess the effects and varieties of PSG with trazodone. METHODS： Polysmith PSG was performed on 21 insomnia patients with depression and 10 normal people. Insomnia patients with depression were cared with trazodone and PSG was undertaken again two months later. Efficacies were assessed using the self-rating depression （SDS） and the Hamilton anxiety scale （HAMA） before and at the end of the second month treatment. Data were figured by x^-± s and analized by SPSS 11.0 software. RESULTS： After trazodone treatment, PSG showed： total sleep time prolonged （350 ± s 30） min in comparing with （393 ± 27） min, P 〈 0.01; sleep efficiency index increased （74.0 ± 2.0） % comparing with （86 ± 4） %, P〈 0.05; wake-up onset after sleep shortened （82 ± 7） min comparing with （19 ± 5） min, P 〈 0.01 ; REM time reduced （107 ± 13） min comparing with （98 ± 7） min, P 〈 0.01 ; S2 time decreased （189 ± 5） min comparing with （181 ± 4） min, P〈 0.05; non-REM slow-wave sleep prolonged （40 ± 3） min comparing with （69.0 ± 2.0） min, P 〈 0.01 ; no significant difference in sleep latent period, REM latency, REM times and S1 time （P 〉 0.05） . SDS and HAMA were better. CONCLUSION： Insomnia patients with depression had abnormal PSG would be effected by trazodone treatment and also good to abnormal night physiological signals on PSG. Trazodone caused an improvement in subjective and objective sleep quality.