抑郁患者选择性5-羟色胺再摄取抑制剂治疗与周期性肢体运动综合征

Relationship between selective serotonin reuptake inhibitor and periodic limb movement syndrome in patients with depression

目的:考察选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor,SSRI)与抑郁患者的周期性肢体运动综合征(periodic limb movement syndrome,PLMS)的关系。方法:本研究是病例回顾性分析,来自广东省精神卫生研究所的多导睡眠图(polysomnography,PSG)数据库(2006年11月-2009年11月)。选择了31例接受SSRI治疗的抑郁患者组(治疗组),并设定了2个对照组:27例未接受药物治疗抑郁患者组(未治疗组)和31例正常对照组。根据2007版美国睡眠研究会标准,判定了睡眠分期、睡眠相关事件和PLMS。结果:SSRI治疗组(13.7±2.6)比未治疗组(5.3±1.4)和正常对照组(4.1±1.1)的周期性肢体运动指数(periodic limb movement index,PLMI)更高(F=10.373,P<0.001),而且治疗组的PLMS发生率(41.9%)明显高于其他两组(未治疗组:11.1%,正常对照组:6.5%,χ2=10.227,P<0.001)。logistic回归显示的SSRI剂量越高(OR=1.107,1.036～1.184)、REM潜伏期越长(OR=1.289,1.176～1.413)和微觉醒越多(OR=1.483,1.219～1.748),接受SSRI的被治疗者就越容易出现PLMS。结论:选择性5-羟色胺再摄取抑制剂可能增加了抑郁患者出现周期性肢体运动综合征的风险,是一个值得临床学家重视的药源性副反应。

Objective： To investigate the relationship between selective serotonin reuptake inhibitor （ SSRI） and periodic limb movement syndrome （ PLMS ） in depressive patients. Methods： It was a retrospective study. Thirty-one depressive patients in SSRI treatment were recruited from the polysomnography database. Two comparing groups were recruited at the same time- 27 depressive without any pharmacological treatment and 31 normal controls. According to the American Academy of Sleep Medicine （ AASM ） Manual, the stage of sleep, events in sleep and PLMS were evaluated. Results： Compared to no treatment group （ 5.3 ±1.4 ） and normal control group （ 4. 1 ±1.1 ）, SSRI group （ 13.7 ± 2. 6 ） experienced more periodic limb movement index （ PLMI） （F = 10. 373, P 〈 0. 001 ） . The prevalence of PLMS in SSRI group （ 41.9% ） was much higher than no treatment group （11. 1% ） and normal control group （6.5%） （X^2 = 10.227, P 〈0.001 ） .Furthermore, the logistic regression revealed that higher SSRI dosage （ OR = 1. 107, 1. 036± 1. 184）, longer REM latency （ OR = 1. 289, 1. 176 ± 1.413）, and higher arousal index （OR = 1.483, 1.219 ± 1.748） were risk factors for PLMS in SSRI group. Conclusion： SSRI may increase the risk of periodic limb movement syndrome in the depressive patients, so it may be an important side effect in SSRI treatment.