小剂量氯胺酮对产后抑郁患者睡眠的影响

Effect of low dose ketamine on sleep of patients with postpartum depression

目的探讨静脉注射小剂量氯胺酮对产后抑郁患者多导睡眠图(polysomnography,PSG)、匹兹堡睡眠质量指数(pitsburgh sleep quality index,PSQI)及爱丁堡产后抑郁评分(edinburgh postnatal depression scale,EPDS)的影响,为临床治疗产后抑郁提供参考。方法将60例爱丁堡产后抑郁评分≥10分的患者随机分为2组(n=30):氯胺酮组(K组)和生理盐水组(N组),K组静脉注射盐酸氯胺酮0.6 mg/kg,N组静脉注射生理盐水,分别于治疗前(T0)、治疗后2 d(T1)、治疗后4 d(T2)检测并记录2组患者的多导睡眠图、匹兹堡睡眠质量指数及爱丁堡产后抑郁评分。结果 2组患者病史、年龄、身高、体重及孕周比较差异无统计学意义(P>0.05),与N组比较,K组在T1、T2时的总睡眠时间增加,睡眠潜伏期、快速动眼睡眠时间、快速动眼睡眠潜伏期缩短,睡眠效率提高,觉醒次数减少,差异有统计学意义(P<0.05);与N组比较,K组在T1、T2时的PSQI更小,差异有统计学意义(P<0.05);与N组比较,K组在T1、T2时的EPDS更低,差异有统计学意义(P<0.05)。与T0时比较,K组在T1、T2时的总睡眠时间增加,睡眠潜伏期、快速动眼睡眠时间、快速动眼睡眠潜伏期缩短,睡眠效率提高,觉醒次数减少,差异有统计学意义(P<0.05);与T0时比较,K组在T1、T2时的PSQI更小,差异有统计学意义(P<0.05);与T0时比较,K组在T1、T2时的EPDS更低,差异有统计学意义(P<0.05)。结论小剂量氯胺酮可显著改善产后抑郁患者的睡眠。

Objective To evaluate the effect of low dose ketamine onpolysomnography（ PSG）,pitsburgh sleep qualityindex（ PSQI） and edinburgh postnatal depression scale（ EPDS） of patients with postpartum depression（ PPD）. Methods Sixty EPDS≥10 patients were divided randomly into 2 groups（ n = 30 each） ： ketamine group（ group K） and normal saline group（ group N）. The patients in group K were intravenously administrated 0. 6 mg / kg ketamine. The patients in group N were intravenously administrated normal saline. The EPDS,PSG and PSQI of patients were determined before treated（ T0）,two days（ T1） after treated,and four days after treated（ T2）. Results Compared with group N,the TST and SE of patients in group K were increasedat T1 and T2（ P 〈 0. 05）; Compared with group N,the SIP,REM,RIP and AN of patients in group K were decreased at T1 and T2（ P 〈 0. 05）. Compared with group N,the PSQI and EPDS of patients in group K were decreased at T1 and T2（ P 〈 0. 05）. Compared with T0,the TST and SE of patients in group K were increasedat T1 and T2（ P 〈 0. 05）; Compared with T0,the SIP,REM,RIP and AN of patients in group K were decreased at T1 and T2（ P 〈 0. 05）. Compared with T0,the PSQI and EPDS of patients in group K were decreased at T1 and T2（ P 〈0. 05）. Conclusion Low dose ketamine could significantly improved sleep quality of patients with PPD.