正常睡眠周期消失患者临床及24小时动态脑电图特点初步研究

Clinical and 24 h ambulatory EEG characteristics of patients with disappearance of normal sleep cycle

目的探究正常睡眠周期消失患者临床及24h动态脑电图特点以及与意识状态、背景节律和痫样放电间的关联性。方法选择2013年1月~2017年8月在解放军总医院就诊并行24h动态脑电图正常睡眠周期消失患者115例,按照年龄分为少年组8例(16~19岁),青年组22例(20~44岁),中年组21例(45~59岁),老年组64例(60~97岁)。所有患者采用意大利EB Neuro EB light 32通道动态脑电监测系统进行脑电图检测。结果不同意识状态患者背景节律比较,差异无统计学意义(χ~2=7.504,P=0.085)。不同背景节律患者痫样放电情况比较,差异无统计学意义(χ~2=6.026,P=0.396)。脑电图背景节律与痫样放电无相关性(P>0.05)。不同年龄组脑电图背景节律分析发现,年龄增长与背景节律慢化相关(P<0.05)。单因素logistic回归分析显示,性别、年龄、病因、意识状态及痫样放电与正常睡眠周期消失无相关性(P>0.05)。背景节律对睡眠周期存在与否有影响及预测意义(OR=16.445,95%CI:4.181~64.677,P=0.000)。结论正常睡眠周期消失是一种严重的脑电图异常,提示颅脑存在不同程度的损伤。背景节律可能影响正常睡眠周期或有一定的预测意义。

Objective To study the clinical and ambulatory EEG characteristics of patients with disappearance of normal sleep cycle and their relationship with consciousness status,background rhythm and epileptiform discharge.Methods One hundred and fifteen patients with disappearance of normal sleep cycle who underwent 24 hambulatory EEG in our hospital were divided into16-19 years old group（n=8）.20-44 years old group（n=22）,45-59 years old group（n=21）,and 60-97 years old group（n=64）.Their ambulatory EEG was monitored with 32-channel EB Neuro EB Light from Italy.Results No significant difference was found in background rhythm and epileptiform discharge between patients with a different consciousness status or with a different background rhythm（χ-2=7.504,P=0.085;χ-2=6.026,P=0.396）.The EEG background rhythm was not related with the epileptiform discharge（P〈0.05）.EEG background rhythm analysis showed that increased age was related with slowing EEG background rhythm（P〈0.05）.Univariate logistic regression analysis showed that gender,age,cause of disease,consciousness status and epileptiform discharge were not related with the disappearance of normal sleep cycle（P〈0.05）.The EEG background rhythm could affect the normal sleep cycle and could thus play a role in predicting the presence or absence of normal sleep cycle（OR=16.445,95%CI：4.181-64.677,P=0.000）.Conclusion Disappearance of normal sleep cycle is a severe abnormal signal on EEG,suggesting a different extent of brain injury.The EEG background rhythm can affect the normal sleep cycle and can thus play a role in predicting the presence or absence of normal sleep cycle.