未用药精神分裂症患者睡眠结构的meta分析

Sleep architecture in drug naive patients with schizophrenia:A meta-analysis

目的:系统分析未用药精神分裂症患者与正常对照相比睡眠结构的特征性改变。方法:使用关键词"精神分裂症"和"睡眠结构"(或"睡眠紊乱"或"多导睡眠图"等)在MEDLINE、Embase、Springer、PsychINFO、谷歌学术、万方数据库等检索相关文献,发表时间为1980年-2015年,筛选针对未用药精神分裂症患者睡眠结构特点的对照研究,最终共纳入15篇文献,使用文献质量评价量表(NOS)评价纳入研究的文献质量。用Stata13.0软件完成meta统计分析。结果:未用药精神分裂症患者与健康对照相比,总睡眠时间减少,睡眠潜伏期延长(P<0.01),睡眠效率下降,快动眼睡眠潜伏期缩短(均P<0.01)。未用药精神分裂症患者的非快动眼1期睡眠所占比例增加,4期和慢波睡眠期所占比例减少,差异有统计学意义。结论:在排除药物的影响下,精神分裂症患者的睡眠质量明显低于正常对照,表现为总睡眠时间减少(以慢波睡眠减少为著),睡眠潜伏期延长,睡眠效率下降等。

Objective： To assess the characteristics change of sleep architecture in drug naive patients with schizophrenia, compared with healthy control. Methods： The key words including ＂schizophrenia＂ and ＂sleep architecture＂ （or ＂sleep structure＂ or ＂sleep disturbance＂ or ＂polysomnogram＂ and so on） were used to search literatures in MEDLINE, Embase, Springer, PsychlNFO, google scholar, Wanfang data, published from 1980 to 2015. Fifteen studies that compared sleep architecture in drug naive patients with schizophrenia and healthy control were includ- ed. Literature quality evaluation was performed with the Newcastle-Ottawa Scale. The meta-analysis was performed by using Statal3.0 software. Results： Compared to healthy control, the total sleep time decreased （P 〈 0. 01）, the sleep latency increased （P 〈 0. 01）, the sleep efficiency decreased （P 〈 0.01）, and the rapid-eye-movement （REM） sleep latency increased （P 〈 0. 01） significantly in drug naive patients with schizophrenia. The proportion of stage l was increased, and the proportions of stage4 and slow wave sleep stage were decreased, the differences between case and control were statistically significant. Conclusion： In the control of drug effects, patients with schizophrenia may have poorer sleep quality of be poorer than healthy controls, such as the decreased total sleep time, specifically slow wave sleep, prolonged sleep latency and decreased sleep efficiency.