伴自杀意念的复发性抑郁障碍患者多导睡眠图改变研究

Study on the changes of polysomnography in patients with recurrent depression with suicidal ideation

目的:调查伴自杀意念的复发性抑郁障碍患者的多导睡眠图(PSG)特征及PSG参数与抑郁程度、自杀意念的相关性。方法:将2019-01~2020-12佛山市第三人民医院接收的伴自杀意念的复发性抑郁患者40例作为研究组,并招募与研究组人口学特征接近的健康体检人员40例作为对照组;采用汉密尔顿抑郁量表24项(HAMD–24)、贝克自杀意念量表(BSI量表)评测抑郁及自杀意念程度;采用PSG检测总睡眠时间(TST)、睡眠效率(SE)、快速动眼期(REM)活动度(RA)、REM强度(RI)、REM比例、快速眼动睡眠时间(RT)、REM睡眠段数(RSP)、睡眠潜伏期(SL)、非快动眼睡眠第1期(N1)、非快动眼睡眠第2期(N2)、非快动眼睡眠第3期(N3)时间;对比两组受试者的HAMD-24、BSI评分及PSG参数差异,采用Pearson相关性分析HAMD-24、BSI评分与PSG参数的相关性。结果:研究组的HAMD-24、BSI评分显著高于对照组,差异有统计学意义(P<0.05);研究组的TST、SE、REM比例、RT及N3均显著低于对照组;研究组的RA、SL均显著高于对照组,差异有统计学意义(P<0.001);Pearson相关性分析;TST、SE、REM比例、RT及N3与HAMD-24及BSI评分均呈显著的负相关性,RA、SL与HAMD-24及BSI评分呈显著的正相关性(P<0.001)。结论:伴自杀意念的抑郁障碍患者存在总睡眠时间与睡眠效率下降,快速眼动睡眠时间及比例不足,慢波睡眠时间下降,快速动眼期活动度上升及睡眠潜伏期延长等睡眠问题,TST、SE、REM比例、RT、N3RA、SL与HAMD-24及BSI评分有显著的相关性。

Objective:To investigate the characteristics of polysomnography(PSG)in patients with recurrent depressive disorder with suicidal ideation and the correlation of PSG parameters with depression and suicidal ideation.Methods:40 patients with recurrent depression with suicidal ideation accepted by the Third People’s Hospital of Foshan City From January 2019 to December 2020 were as the research group.And recruit 40 health examiners with demographic characteristics similar to the study group as the control group.The 24 items of Hamilton Depression Scale(HAMD-24)and Baker Suicide Ideation Scale(BSI Scale)were used to evaluate depression and suicidal ideation,The PSG were used to detect total sleep time(TST),sleep efficiency(SE),rapid eye movement(REM)activity(RA),REM intensity(RI),REM ratio,rapid eye movement sleep time(RT),number of REM sleep segments(RSP),sleep latency(SL),non-rapid eye movement sleep phase 1(N 1),non-rapid eye movement sleep phase 2(N 2),non-rapid eye movement sleep phase 3(N 3)Time;The differences of HAMD-24,BSI score and PSG parameters of the two groups of subjects were compared,and the correlation between HAMD-24,BSI score and PSG parameters was analyzed by Pearson correlation.Results:The HAMD-24 and BSI scores of the study group were significantly higher than that of the control group,and the difference were statistically significant(P<0.05);The ratios of TST,SE,REM,RT and N 3 of the study group were significantly lower than those of the control group;The RA and SL of the study group were significantly higher than that of the control group,and the difference were statistically significant(P<0.001);Pearson correlation analysis;TST,SE,REM ratio,RT and N 3 and HAMD-24 and BSI scores were all significant Negative correlation,RA,SL,HAMD-24 and BSI score showed a significant positive correlation(P<0.001).Conclusion:Depressive patients with suicidal ideation have sleep problems such as decreased total sleep time and sleep efficiency,insufficient REM sleep time and proportion,decreased slow-wave sleep time,increased REM activity and prolonged sleep latency.TST,SE,REM ratio,RT,N3RA,SL have significant correlation with HAMD-24 and BSI score.