发作性睡病患者的多次睡眠潜伏期试验对照研究

Study of multiple sleep latency test in patients with carcolepsy

目的探讨多次睡眠潜伏期试验(MSLT)对发作性睡病的诊断价值。方法对35例发作性睡病和25例阻塞性睡眠呼吸暂停综合征(OSAS)患者及20名正常对照组进行白天5次MSLT和整夜多导睡眠图(PSG)描记,分析平均睡眠潜伏期(SL)、睡眠初期出现REM(SOREMP)次数及夜间睡眠相关参数。结果MSLT显示发作性睡病组SL缩短(4.6±2.5)min和SOREMPs≥2(2.3±1.2)次,SL<5min+SOREMPs≥2次25例(71%),睡眠次数发作性睡病和OSAS2组比较差异无显著性(P>0.05),组间比较差异有显著性(F=23.58～65.99,P<0.001);整夜PSG结果比较发作性睡病组总睡眠时间(336.81±34.08)min、REM潜伏期缩短(17.21±7.25)min,组间比较差异有显著性(P<0.01),OSAS组显示具有明显呼吸暂停(平均17次以上)和血氧饱和度降低(87%)的特征(P<0.01)。结论发作性睡病患者具有明显的REM睡眠提前和睡眠潜伏期缩短的特征,MSLT对发作性睡病的诊断和鉴别诊断具有重要参考价值。

[Objective] To explore the value of multiple sleep latency test （MSLT） for the diagnosis of patients with narcolepsy. [Methods] The sleep latency and sleep onset rapid eye movement （SOREMP） and sleep parameter of correlative were analyzed in 35 patients with narcolepsy and 25 obstructive sleep apnea syndrome （OSAS） and 20 normal control were determined using MSLT and all-night sleep recording by polysomnography （PSG） measurements. [Results] Compared between groups, the patients with narcolepsy showed the sleep latency mean （4.6±2.5） min was shorter and SOREMPs mean （2.3±1.2） increased. 25（71%） of subjects was diagnostic based on the occurred of two or more SOREMPs with a mean sleep latency〈5 minutes on MSLT, and there was a significant difference （P 〈0.01）. The sleep times were not significandy different in narcolepsy and OSAS patients （P 〉0.05）; The sleep parameters of all-night PSG showed that decreased total sleep time and reduced REM latency were significantly different between the narcolepsy and the sleep apnea syndrome groups （P 〈0.01）; apneas was 17 times or more and SAO2（87%） was lower in OSAS group. [Conclusions] The advance REM sleep and short sleep latency is obvious in the patients with narcolepsy, and it provided an objective measure of biology for clinical treatment.