重复经颅磁刺激对卒中后睡眠障碍患者睡眠结构及脑源性神经营养因子的作用

Effects of repetitive transcranial magnetic stimulation on sleep structure and brain-derived neurotrophic factors in patients with post-stroke sleep disorders

目的研究百乐眠胶囊联合低频重复经颅磁刺激(rTMS)对卒中后睡眠障碍的患者睡眠结构及脑源性神经营养因子(BDNF)水平的影响。方法将92例卒中后睡眠障碍患者随机分2组,每组46例。A组采用百乐眠胶囊+rTMS治疗;B组使用百乐眠胶囊+假刺激治疗。疗程均为2周。2组均采用匹兹堡睡眠质量指数评分(PSQI)及多导睡眠图评价睡眠质量,选用酶联免疫吸附法检验2组患者血清BDNF水平。结果2组患者治疗前PSQI评分、各睡眠参数及血清BDNF水平差异均无统计学意认(P>0.05)。治疗后患者PSQI评分及各睡眠参数均较治疗前有改善(P<0.05),血清BDNF水平升高(P<0.05),A组较B组改善更明显。结论百乐眠胶囊联合低频rTMS能升高卒中后睡眠障碍患者的血清BDNF水平,并缩短患者的睡眠潜伏期及浅睡眠的时间,延长其深睡眠时间。从而大大提高有效睡眠,改善患者的睡眠质量。

Objective To investigate the effects of zolpidem tartrate tablets combined with low frequency repeti-tive transcranial magnetic stimulation(rTMS)on sleep structure and brain-derived neurotrophic factors(BDNF)levels in patients with post-strokd sleep disorders(PSSD).Methods Ninty-two patients with PSSD were randomly assigned to 2 groups.The patients in group A received zolpidem tartrate tablets plus rTMS,and the patients in group B treated with zolpidem tartrate tablets plus sham stimulation treatment for two weeks.Pittsburgh sleep quality index(PSQI),polysomnography(PSG),serum BDNF levels and treatment emergent symptom scale(TESS)were evaluated before and after the treatment in the two groups.Results There were not significant in PSQI score、various sleep parameters and serum BDNF levels before treatment in two groups(P>0.05).The PSQI score and sleep parameters of the two groups after treatment improved compared with those before treatment,and the serum BDNF level increased(P<0.05).The effect in group A was the most obvious compared with group B(P<0.05).Conclusion Zolpidem tartrate tablets combined with low-frequency rTMS can increase serum BDNF levels,shorten the sleep latency and shallow sleep time,prolong the deep sleep time and improve the sleep efficiency of patients with PSSD.