阿立哌唑对强迫症患者睡眠结构的影响

Effect of aripiprazole on the sleep structure in patients with obsessive-compulsive disorder

目的探讨非典型抗精神病药物阿立哌唑对强迫症(OCD)患者睡眠结构的影响。方法根据是否使用阿立哌唑将182例OCD患者中仅服用舍曲林者作为对照组(85例),将服用舍曲林联合2.5~10.0 mg/d阿立哌唑者作为阿立哌唑组(97例)。收集所有患者的一般资料、耶鲁-布郎强迫量表(Y-BOCS)评分、匹兹堡睡眠质量指数(PSQI)量表各因子评分及总分、多导睡眠仪(PSG)监测结果并进行比较。结果阿立哌唑组患者PSQI总分较对照组低,其中睡眠质量、入睡时间、睡眠时间、睡眠效率及日间功能评分均低于对照组(P<0.05)。阿立哌唑组患者较对照组总睡眠时间延长、睡眠效率百分比增加、非快速眼球运动3期(N3期)时间及百分比增加、非快速眼球运动(NREM)期睡眠潜伏期缩短、NREM期时间及百分比增加、清醒(W)期时间及百分比减少(P<0.05)。结论小剂量阿立哌唑干预可改善服用舍曲林的OCD患者的主观睡眠体验,并增加N3期时间和百分比、NREM期时间和百分比及总睡眠时间,减少W期时间。

Objective To explore the effect of atypical antipsychotic drug aripiprazole on the sleep structure of patients with obsessive-compulsive disorder(OCD).Methods According to whether aripiprazole was used,182 OCD patients taking sertraline were selected as the control group(85 cases),and the patients taking sertraline combined with 2.5-10.0 mg/d aripiprazole were selected as the aripiprazole group(97 cases).The general data,Yale-Brown Forced Scale(Y-BOCS)score,Pittsburgh Sleep Quality Index(PSQI)scores for each factor and total scores,and polysomnography(PSG)monitoring results of all patients were collected and compared.Results The total PSQI score of OCD patients in the aripiprazole group was lower than that of the control group,among them,the factor scores of sleep quality,time to fall asleep,sleep time,sleep efficiency and daytime function in the aripiprazole group were lower than those of the control group(P<0.05).Compared with the control group,patients in the aripiprazole group had a longer total sleep time,a higher percentage of sleep efficiency,an increase in the time and percentage of non-rapid eye movement phase 3(N3 phase),a shorter sleep latency in the non-rapid eye movement(NREM)phase,an increase in the time and percentage of NREM phase and a decrease in the time and percentage of W phase(P<0.05).Conclusion Low-dose aripiprazole intervention can improve the subjective sleep experience of OCD patients using sertraline,extend the time and percentage of N3 phase,the time and percentage of NREM phase and total sleep time,reduce the time of W phase.