创伤后应激障碍军人患者多导睡眠图和事件相关电位P300特征

Characteristics of the polysomnography and event-related potentials P300 in military patients with post-traumaticstress disorder

目的:探讨创伤后应激障碍(PTSD)军人患者多导睡眠图(PSG)和事件相关电位P300特征。方法:对36例PTSD军人患者(研究组)PSG和P300检测,并与随机抽取某部32名官兵(对照组)进行比较。结果:PSG检测示:研究组较对照组总睡眠时间缩短,睡眠效率(SE)降低,觉醒次数(AT)增加,慢波睡眠(SWS)S1期延长,S3和S4期缩短,快眼动睡眠(REM)缩短,差异具有统计学意义(P<0.05或P<0.01)。P300检查示:与对照组比较,研究组N2和P3潜伏期(PL)显著延长,P3波幅(Amp)显著降低(P均<0.01);研究组N2、P3潜伏期与AT和睡眠潜伏期(SL)呈正相关(r=0.21~0.28,P<0.05或P<0.01),与SE和REM呈负相关(r=-0.22^-0.39,P<0.05或P<0.01);P3Amp与AT和SL呈负相关(r=-0.22^-0.23,P均<0.05),与SE和REM呈正相关(r=0.25~0.28,P<0.05或P<0.01)。结论:PTSD军人患者存在睡眠结构紊乱和认知功能损伤,且二者相互影响。

Objective： To investigate the characteristics of the polysomnography（ PSG） and event-related potentials P300 in military patients with post-traumaticstress disorder（ PTSD）. Method： Thirty-six PTSD military patients（ study group） were detected by PSG and event-related potentials P300; and the results were compared with 32 healthy soldiers（ control group） assigned randomly. Results： PSG： Compared to the control group,the total sleep time and sleep efficiency（ SE） in the study group were significantly reduced,awakening times（ AT） was significantly increased（ P〈0. 05 or P〈0. 01）; slow wave sleep（ SWS） S1 stage was extended,S3,S4 and rapid eye movement sleep（ REM） were shorter（ P〈0. 05 or P〈0. 01）. P300： Compared to the control group,the N2 and P3 latency（ PL） in the study group were significantly extended,P3 amplitude（ Amp） was significantly lower（ all P〈0. 01）. In the study group,the PLs of N2,P3 were positively correlated with AT and sleep latency（ SL）（ r = 0. 21- 0. 28,P〈0. 05 or P〈0. 01）,negatively correlated with SE and REM（ r =- 0. 22-0. 39,P〈0. 05 or P〈0. 01）; Amp of P3 was negatively correlated with AT and SL（ r =- 0. 22- 0. 23; all P〈0. 05）,and positively correlated with SE and REM（ r = 0. 25- 0. 28,P〈0. 05 or P〈0. 01）. Conclusion： The sleep structure and cognitive function in PTSD military patients are impared,and both influence each other.