夜间视频脑电图分析单症状性夜遗尿儿童睡眠的研究

Analysis of sleep in children with monosymptomatic nocturnal enuresis by nocturnal video electroencephalogram

目的:通过夜间视频脑电图分析单症状性夜遗尿(MNE)儿童的睡眠状态,以探寻MNE的病理机制。方法:纳入32例MNE患儿和30名年龄匹配的正常对照儿童,采用夜间持续性视频脑电图监测15 h,完成至少1个完整的清醒-自然入睡-清醒周期记录,比较两组儿童睡眠时相,并分析MNE患儿发生遗尿事件时的睡眠时相特点。结果:MNE组儿童N1期和觉醒时间明显高于对照组,N2期明显低于对照组,差异均有统计学意义(P<0.05),N3期和REM期比较差异均无统计学意义(P>0.05),MNE组儿童觉醒时间明显长于对照组,差异均有统计学意义(P<0.05)。32例MNE患儿中,尿床发生于N2期睡眠为17例(53.13%),发生于N3期为10例(31.25%),发生于REM期为5例(15.62%),N1期未发现有尿床事件发生,尿床事件主要发生于浅睡眠阶段。结论:MNE患儿尿床事件主要发生于浅睡眠阶段,且MNE患儿存在睡眠周期紊乱及觉醒异常的睡眠障碍,这有助于进一步研究MNE的发病机制,且可能对临床治疗有一定的指导意义。

Objective To analyze the sleep state of children with monosymptomatic nocturnal enuresis(MNE) by nocturnal video electroencephalogram in order to explore the pathological mechanism of MNE.Method Thirty two children with MNE and 30 age-matched normal controls were enrolled in the study. They were monitored by continuous video EEG at night for 15 hours to complete at least one complete awake natural sleep awake cycle. The sleep phases of the two groups were compared, and the sleep characteristics of MNE children with enuresis were analyzed.Results The awakening time and N1 phase in MNE group were significantly higher than those in control group, N2 phase was significantly lower than that in control group, the differences were statistically significant(P<0.05), there was no significant difference between N3 phase and REM phase(P>0.05), the awakening time in MNE group was significantly longer than that in control group, the differences were statistically significant(P<0.05). In 32 cases of MNE, 17 cases(53.13%) had bed wetting in N2 phase, 10 cases(31.25%) in N3 phase and 5 cases(15.62%) in REM phase. No bed wetting event was found in N1 phase, and bed wetting events mainly occurred in light sleep phase.Conclusion Bed wetting in children with MNE mainly occurs in the stage of light sleep, and the children with MNE have sleep disorder of sleep cycle disorder and abnormal awakening, which is helpful to further study the pathogenesis of MNE and may have certain guiding significance for clinical treatment.