夜间呻吟1例报告及文献复习

Catathrenia:A case report and literature review

目的:探讨夜间呻吟患者的发病机制、临床表现、诊断思路和治疗方法,提高临床医生对该疾病的认识,为其临床诊治提供依据。方法:回顾性分析1例夜间呻吟患者的临床资料,将诊治经过进行总结,并结合相关文献复习探讨夜间呻吟患者的临床特点和诊治方法。结果:患者,女性,28岁,因睡眠中间断呻吟3年就诊。既往体健,无不良嗜好,作息规律。查体未见明显阳性体征,行心电图、胸片、颅脑CT平扫、纤维喉镜和多导睡眠图(PSG)等相关检查。PSG表现为深吸气后出现呼气相延长,随后为短暂的深吸气和呼气,呼吸节律减慢,觉醒指数和呼吸事件指数多升高,无血氧饱和度下降。根据患者的临床表现及PSG表现,诊断为夜间呻吟,排除中枢性睡眠呼吸暂停(CSA)的可能,应用持续气道正压通气(CPAP)治疗,效果良好,随访2年病情稳定。结论:夜间呻吟相对少见,其发病机制、诊断和治疗目前尚不明确,临床上以患者的临床表现和PSG表现为诊断依据,应用CPAP治疗,预后较好。

Objective:To explore the pathogenesis,clinical manifestations,diagnosis and treatment of the patient with catathrenia,to improve the clinician’s understanding of the disease,and to provide the evidences for its diagnosis and treatments.Methods:The clinical data of a patient with catathrenia were retrospectively analyzed and the diagnosis and treatment were summarized;the relevent literatures were reviewed,and the clinical characteristics and diagnosis and treatment methods were explored.Results:The patient was a 28 years old woman with intermittent catathrenia for 3 years and went to hospital.She was healthy in the past,had no bad habits,and had regular work and rest.There were no abnormal signs on physical examination.The relevant examinations including electrocardiogram,chest radiograph,CT scan of the brain,fibrolaryngoscope and polysomnography(PSG)were performed.The PSG results showed exhalation prolongation after deep inhalation,followed by brief deep inhalation and exhalation.The respiratory rhythm slowed down,the arousal index and respiratory event index increased,and there were no oxygen saturation decreases.According to the patient’s clinical manifestations and the PSG manifestations,the patient was diagnosed as catathrenia,and the possibility of central sleep apnea(CSA)was excluded.The application of continuous positive airway pressure(CPAP)was effective,and the condition was stable during the follow-up of two years.Conclusion:Catathrenia is relatively rare,and its pathogenesis,diagnosis and treatment are not clear at present.The patient’s clinical manifestations and PSG manifestations are used clinically as a basis for diagnosis.The application of CPAP has a better prognosis.