慢性失眠患者日间脑功能状态改变及其与血清生物学标志和睡眠质量的相关性

Correlations of diurnal brain functional variations with serum biomarkers and objective sleep quality in patients with chronic insomnia disorder

目的探讨慢性失眠(CID)患者日间脑功能状态及其与血清生物学标志和客观睡眠质量的相关性。方法连续收集2018年3月至2019年6月于安徽医科大学附属巢湖医院睡眠障碍科就诊的CID患者60例和本院同期健康体检中心的正常睡眠志愿者30名(健康对照组)。用“脑功能状态定量测量系统”评估日间脑功能状态,ELISA法检测血清促肾上腺激素释放激素(CRH)、胶质纤维酸性蛋白(GFAP)含量。CID组还检查多导睡眠图(PSG)。分析得出CID组具有显著性改变的脑功能状态指标,并且分析这些指标与血清生物学标志、客观睡眠质量的一致性。结果CID患者中男23例,女37例;健康对照组中男15名,女15名。CID组脑功能状态指标中4个即脑惰性[M(Q1,Q2)][196.0(163.0,258.0)]、脑混沌[5.0(1.0,10.0)]、内专注[31.0(13.0,45.0)]、内源性焦虑值[12.0(4.0,18.0)]高于健康对照组[168.5(148.8,182.5)、0(0,2.0)、2.0(0,27.5)、0(0,6.5),均P<0.05],1个指标即脑抑制值[47.0(32.0,58.0)]低于健康对照组[59.0(46.3,66.3),P<0.05]。脑混沌值与血清GFAP浓度正相关(r=0.374,P=0.006),脑惰性值与血清CRH浓度正相关(r=0.299,P=0.031),脑抑制值与睡眠潜伏期正相关(r=0.284,P=0.042);内专注值与睡眠效率(r=-0.276,P=0.048)、1期持续时间(r=-0.341,P=0.024)负相关。结论CID患者脑电波中脑功能状态指标有显著性改变,且与血清生物学标志和客观睡眠质量关联。

Objectives To investigate the correlations of diurnal brain functional variations with serum biomarkers and objective sleep quality in patients with chronic insomnia disorder(CID).Methods A total of 60 CID patients and 30 healthy sleep volunteers who visited Department of Sleep Disorders of Chaohu Hospital affiliated to Anhui Medical University from March 2018 to June 2019 were collected.Diurnal brain function state was evaluated by Quantitative Measurement System of Brain Functional Status,and serum concentrations of corticotropin-releasing hormone(CRH)and glial fibrous acidic protein(GFAP)were detected using enzyme-linked immunosorbent assay(ELISA).The sleep quality in the CID group was evaluated using ploysomnography(PSG)at the same time.The brain function status indicators with significant changes in CID group were acquired,and the consistency of these indicators with serum biological markers and objective sleep quality was analyzed.Results There were 23 males and 37 females in chronic in somnia patients;15 males and 15 females in the healthy control group.Compared with the healthy controls,four brain function indicators of CID patients increased (brain inertia(196.0(163.0,258.0)vs 168.5(148.8,182.5)),brain chaos(5.0(1.0,10.0)vs 0(0,2.0))),internal concentration(31.0(13.0,45.0)vs 2.0(0,27.5))and endogenous anxiety(12.0(4.0,18.0)vs 0(0,6.5)),but one indicator decreased(brain inhibitory value(47.0(32.0,58.0)vs 59.0(46.3,66.3)))(all P<0.05).The brain chaos value positively correlated with the serum GFAP level(r=0.374,P=0.006),and the brain inertia value positively correlated with the serum CRH level(r=0.299,P=0.031).The value of brain inhibition positively correlated with the sleep latency(r=0.284,P=0.042).However,the values of internal concentration negatively correlated with the sleep efficiency(r=-0.276,P=0.048)and the time in non-rapid eye movement sleep stage 1(r=-0.341,P=0.024).Conclusion The brain waves of CID patients show significant changes in their brain function indicators,which are related to serum biological markers and objective sleep quality.