64例不同年龄段发作性睡病患者临床症状和多导睡眠监测结果的特征性分析

Characteristic analysis of clinical symptoms and polysomnography results of 64 patients with narcolepsy at different ages

目的分析不同年龄段发作性睡病患者的临床症状和多导睡眠监测结果的特征。方法收集64例发作性睡病患者的临床资料,分为≤18岁青少年组37例,>18岁成人组27例,对比其临床症状、多导睡眠监测和多次睡眠潜伏期试验的结果。结果64例患者均表现为日间嗜睡,两组睡前幻觉和睡瘫发生率无统计学差异,青少年组猝倒发生率明显高于成人组(P<0.05),青少年组的夜间失眠障碍、阻塞性睡眠呼吸暂停、周期性肢体运动障碍和快速眼球运动(REM)睡眠行为障碍的发生率均明显低于成人组(均P<0.05),而精神障碍的发生率则明显高于成人组(P<0.05)。成人组睡眠质量较青少年组差(P<0.05),且呼吸暂停指数和腿动指数值均明显高于青少年组(均P<0.05);两组平均睡眠潜伏期差异无统计学意义,但平均REM睡眠潜伏期和入睡期始发的REM睡眠差异有统计学意义(均P<0.05)。结论不同年龄段发作性睡病临床特征和多导睡眠监测结果存在显著差异,识别典型症状的同时应积极排查非典型症状和伴随疾病,及时有效的评估和完备的多导睡眠监测有助于提高诊断效能。

Objective To analyze the clinical symptoms and the characteristics of polysomnography in patients with narcolepsy at different ages.Methods The clinical data of 64 patients with narcolepsy were collected and divided into the adolescent group(n=37)with age≤18 years old and the adult group(n=27)with age>18 years old.The clinical symptoms,results of polysomnography and multiple sleep latency test were compared between the two groups.Results All the 64 patients showed daytime drowsiness,and there was no significant difference in the incidence of pre-bedtime hallucinations and sleep paralysis between the two groups.The incidence of cataplexy in adolescent group was significantly higher than that in adult group(P<0.05);the incidences of insomnia disorder,obstructive sleep apnea,periodic limb movement disorder and rapid eye movement(REM)sleep behavior disorder in the adolescent group were significantly lower than those in the adult group(all P<0.05),while the incidence of mental disorder in the adolescent group was significantly higher than that in the adult group(P<0.05).The sleep quality in the adult group was worse than that in the adolescent group(P<0.05),and the apnea index and leg movement index in the adult group were significantly higher than those in the adolescent group(all P<0.05).There was no significant difference in mean sleep latency between the two groups,but there were significant differences in mean REM sleep latency and sleep onset REM period between the two groups(all P<0.05).Conclusions There are significant differences in the clinical characteristics and the results of polysomnography of narcolepsy between different age.Apart from the the typical symptoms,atypical symptoms and concomitant diseases should be concerned in narcolepsy with different age.Meanwhile,timely effective evaluation and accurate of polysomnography are helpful to improve the diagnostic efficiency.