老年失眠症患者艾司唑仑治疗前后睡眠脑电Quisi及失匹性负波观察

AN OBSERVATIVE STUDY OF CHANGE ON QUISI AND MISMATCHING NEGATIVITY(MMN) BEFORE AND AFTER ESTAZOLAM TREATMENT IN ELDERLY PATIENTS WITH INSOMNIA

目的:目的:探讨老年失眠症患者艾司唑仑治疗前后睡眠脑电(Quisi)及失匹性负波变化。方法:对64例老年失眠症患者连续进行4夜Quisi描记,其中第3、4晚上睡前予2mg艾司唑仑,观察用药后Quisi的变化。正常老人组56名,做2夜适应和基础Quisi监测。结果:(1)老年失眠症患者服用艾司唑仑后夜间Quisi显示睡眠效率提高(基线睡眠值87.5%±8.1%,第3晚服药后91.2%±7.9%,第4晚服药后91.9%±3.2%,F值5.94,P<0.05),觉醒时间减少(同前,37.9±16.1分,28.4±7.5分,24.3±6.5分,F值7.21,P<0.01),S1减少(同前,30.9±18.2%,24.1±11.0%,16.2±6.2%,F值8.90,P<0.01),S2增加(同前,43.0±16.3%,59.1±17.2%,59.1±5.7%,F值7.61,P<0.01),睡眠潜伏期缩短(同前,34.6±18.9分,26.9±16.5分,20.4±10.9分,F值3.95,P<0.05)。(2)与正常老人组相比,老年失眠症患者在MMN潜伏期延迟,波幅下降(P<0.01)。与此同时,P300也见同一趋势变化(P<0.05或0.01)。结论:(1)艾司唑仑不仅能改善老年患者对睡眠的主观评价,还对夜间睡眠脑电有影响。(2)我们的临床经验并建议,对普通及老年失眠症患者治疗首选艾司唑仑。

Objective： To explore the change of sleep EEGs （Quisi） and Mismatching Negativity （MMN） before and after Estazolam treatment in elderly patients with insomnia. Methods： Four consecutive nights sleep EEGs （Quisi） were recorded in 64 elderly patients with insomnia, which administrated 2mg Estazolam before sleep during the 3rd and 4th nights. For 56 controls （NC） , sleep EEGs （Quisi） were recorded in 2 adaptation and 2 baseline nights. Results： （1） After taking estalolam, elderly patients with insomnia presented better sleep efficiency （baseline： 87.5± 8.1%, 3rd administration： 91.2±7.9%, 4th administration： 91.9 ± 3.2%, F=5.94, P 〈 0.05） , reduced awakening time （baseline： 37.9± 16.1, 3rd administration： 28.4±7.5, 4th administration： 24.3±6.5, F=7.21, P 〈 0.01） , reduced stage 1 time （baseline： 30.9± 18.2%, 3rd administration： 24.1± 11.0%, 4th administration： 16.2±6.2%, F=8.90, P 〈 0.01） , increased time of stage 2 （baseline： 43.0± 16.3%, 3rd administration： 59.1±17.2%, 4th administration： 59.1±5.7%, F=7.61, P 〈 0.01） , shortened sleep latency （baseline：34.6± 18.9, 3rd administration：26.9± 16.5, 4th administration：20.4± 10.9, F=3.95, P 〈 0.05） . （2） Compared with the NC, the MMN in elderly patients with insomnia had decreased amplitude and increased latency.Meanwhile,P300 also has the same tendency （P 〈 0.05 or 0.01 ） on sleep and has some effect on sleep EEGs Conclusion： （1） Estazolam can improve subjective evaluation （Quisi） in patients with insomnia. （2） Based on our clinical experience, we suggest the preferable choice for patients with insomnia is estazolam.