血管迷走神经性晕厥患者的多导睡眠图特点

Characteristics of sleep disorders in vasovagal syncope patients

目的 分析血管迷走神经性晕厥(VVS)患者的多导睡眠图特点。方法 收集2020-09—2022-06于郑州大学第二附属医院神经内科就诊的VVS患者40例和健康体检者45例(对照组),应用多导睡眠监测对2组睡眠结构进行分析。结果 与对照组相比,VVS患者睡眠质量降低,快速眼球运动睡眠期[分别为(17.97±0.96)%、(23.88±4.45)%,t=8.226,P<0.01]和慢波睡眠(N3期)[分别为(13.3±10.17)%、(21.76±6.42)%,t=4.638,P<0.05]比例降低,N1期[分别为(10.85±16.45)%、(4.95±5.34)%,t=2.379,P<0.05]和N2期[分别为(59.88±10.5)%、(49.41±6.5)%,t=5.593,P<0.01]睡眠比例增加,微觉醒指数[分别为9.3(7.05,12.5)、4.3(3.2,5.5),Z=—5.567,P<0.01]以及觉醒次数[分别为56(40,85.5)、25(19,34),Z=—5.4,P<0.01]升高。结论 VVS患者的睡眠质量差,夜间睡眠结构紊乱,表现为浅睡眠增多,深睡眠减少,觉醒次数增加,可能与VVS患者交感神经活性的增强、5-羟色胺递质的紊乱以及反复脑缺血等相关。

Objective To analyze the characteristics of polysomnography in vasovagal syncope(VVS)patients.Methods We enrolled 40 VVS patients who visited the Department of Neurology of the Second Affiliated Hospital of Zhengzhou University from September 2020 to June 2022 and 45 healthy controls,and polysomnography were used to analyze and compare the sleep quality and sleep structure of the two groups.Results VVS patients had reduced sleep quality compared with that of the control group,and periods of rapid eye movement(REM)sleep(17.97%±0.96% and 23.88%±4.45%,respectively,t=8.226,P<0.01)and slow-wave sleep(N3)(13.3%±10.17% and 21.76%±6.42%,respectively,t=4.638,P<0.05)were proportionally reduced;the proportion of N1(10.85%±16.45% and 4.95%±5.34%,respectively,t=2.379,P<0.05)and N2 sleep(59.88%±10.5% and49.41%±6.5%,t=5.593,P<0.01)increased,as did the microarousal index(9.3(7.05,12.5)and 4.3(3.2,5.5),Z=— 5.567,P<0.01,respectively)and the number of awakenings(56(40,85.5)and 25(19,34),Z=— 5.4,P<0.01).Conclusion VVS patients have poor sleep quality and disturbed nocturnal sleep structure,which is characterized by increased light sleep,decreased deep sleep,and increased number of awakenings.This may be related to increased sympathetic nerve activity,disturbances in serotonin transmitters,and recurrent cerebral ischemia in VVS patients.