多发性抽动症患儿睡眠结构与认知行为关系研究

Study of relation between sleep macrostructure and cognitive behavior in children with tourette syndrome

【目的】探讨多发性抽动症(tourette syndrome,TS)患儿的睡眠结构改变与认知行为关系异常的关系。【方法】对52例TS患儿进行全夜睡眠多导监测,瑞文测试及划消试验测试其智商和注意力评价其认知能力及Achen-bach量表评估其行为状态,应用秩相关系数分析睡眠与注意力、行为的相关性,并与40名正常儿童(作为正常对照组)进行比较。【结果】与正常对照组相比,TS组睡眠效率(SE)、慢波睡眠百分比较对照组低,睡眠潜伏期(ST)延长,NREMⅠ期睡眠百分比较对照组高,觉醒次数(WASO)多;TS组划消试验注意力各项参数较对照组明显升高;TS组患儿CBCL评分总分及内向行为评分均较对照组高;注意力划消总指数与NREMⅠ呈正相关(r=0.72,P<0.01),行为问题总分与REM百分比呈正相关(r=0.59,P<0.05)。【结论】TS患儿睡眠结构异常,其与患儿认知及行为异常有关。

【Objective】 To investigate the alteration of sleep macrostructure in children with tourette syndrome（TS） and study the relationship between sleep macrostructure and cognitive-behavioral abnormality. 【Methods】 Full-night polysomnography monitoring,Combined Raven Test（CRT）,symbols cancellation test and Achenbach Child Behavior Checklist were done on 52 children with TS and 40 normal children were control group.Rank correlation coefficient analysis was made to evaluate the correlations between the parameters of sleep macrostructure and cognitive-behavioral abnormality. 【Results】 Comparing with normal control group,sleep efficiency（SE） and percentage of slow wave sleep declined,and sleep latency（ST） extended in TS group.The percentage of NREMⅠ and the frequency of awakening（WASO） in TS group was higher than the control group.The symbols cancellation test overall index and Achenbach score were higher than those of controls.The analysis of rank correlation coefficient showed cancellation test overall index had positive correlation with NREM Ⅰstage（r = 0.72,P 〈0.01）;the total score of behavioral problems was positively correlated with the percentage of REM（r = 0.59,P〈 0.05）. 【Conclusions】 Sleep macrostructure in children with tourette syndrome is abnormal which are related with cognitive and behavioral abnormalities.