脑内神经递质水平对睡眠障碍的诊断价值及重复经颅磁刺激干预效果评价

The diagnostic value of neurotransmitter expression level in the brain for sleep disorders and evaluation of the effect of repeated transcranial magnetic stimulation intervention

目的探讨脑内神经递质表达水平对睡眠障碍的诊断价值及重复经颅磁刺激的干预效果.方法将80例睡眠障碍患者设为研究组,78名健康体检者设为健康组,比较研究组与健康组脑内神经递质水平.将研究组按照随机数字表法分为常规组与联合组,每组40例,均给予阿普唑仑片治疗,联合组联合重复经颅磁刺激治疗,观察14 d.比较治疗前后常规组与联合组临床疗效、脑内神经递质水平及多导睡眠监测情况.结果 研究组脑内γ-氨基丁酸、谷氨酸、5-羟色胺水平显著低于健康组(P<0.01),乙酰胆碱、去甲肾上腺素、多巴胺水平显著高于健康组(P<0.01).联合组治疗总有效率显著高于常规组(P<0.05).治疗后常规组与联合组γ-氨基丁酸、谷氨酸、5-羟色胺水平显著高于治疗前(P<0.01),乙酰胆碱、去甲肾上腺素、多巴胺水平显著低于治疗前(P<0.01),联合组较常规组变化更显著(P<0.01).治疗后两组睡眠潜伏期显著缩短(P<0.01),睡眠效率显著上升(P<0.01),觉醒次数显著减少(P<0.01),总睡眠时间显著增加(P<0.01),联合组较常规组变化更显著(P<0.01).结论脑内神经递质表达水平异常与睡眠障碍发病过程关系密切,重复经颅磁刺激能有效活化睡眠障碍患者的神经递质,改善睡眠状态,临床可通过观察脑内神经递质活动指数评估预后.

Objective To investigate the diagnostic value of neurotransmitter expression level in the brain for sleep disorders and the effect of repeated transcranial magnetic stimulation.Methods 80 patients with sleep disorders were set as the study group,and 78 healthy medical examinees were set as the healthy group.The neurotransmitter levels in the brain of the study group and the healthy group were compared.The study group was divided into a conventional group and a combined group according to the random number table method,40 cases in each group were all treated with alprazolam tablets,and the combined group was combined with repeated transcranial magnetic stimulation treatment.The clinical efficacy,neurotransmitter levels in the brain and polysomnography detection in the conventional group and the combined group were compared before and after treatment.Results The levels of GABA,Glu and 5-HT in the study group were significantly lower than those in the healthy group(P<0.01),and the levels of Ach,NE and DA were significantly higher than that in the healthy group(P<0.01).The total effective rate of treatment in the combination group was significantly higher than that in the conventional group(P<0.05).After treatment,the levels of GABA,Glu,5-HT in the conventional group and the combined group were significantly higher than before treatment(P<0.01).The levels of Ach,NE and DA were significantly lower than before treatment(P<0.01),and the changes in the combined group were more significant than those in the conventional group(P<0.01).After treatment,the sleep latency of the two groups was significantly shortened(P<0.01),the sleep efficiency was significantly increased(P<0.01),the number of awakenings was significantly reduced(P<0.01),the total sleep time was significantly increased(P<0.01),the combined group had more significant changes than the conventional group(P<0.01).Conclusions Abnormal expression of neurotransmitters in the brain is closely related to the pathogenesis of sleep disorders.Repeated transcranial magnetic stimulation can effectively activate the neurotransmitters in patients with sleep disorders and improve sleep status.Clinically,the prognosis can be evaluated by observing the neurotransmitter activity index in the brain.