不同年龄正常人睡眠时锥体束抑制情况的研究

目的探讨不同年龄正常人睡眠时锥体束抑制的情况。方法 53名健康体检者按年龄分为7组:≤2岁组、3～4岁组、5～6岁组、7～10岁组、11～14岁组、15～17岁组和成人组。予以睡眠监测,并于入睡后不同睡眠时期进行Babinski征与手指征检查,对结果进行统计分析。结果 14岁及以下各组少儿睡眠期Babinski征阳性率均为100%,均显著高于成人组(53.3%),差异有统计学意义(均P<0.05)。≤2岁组儿童睡眠期手指征阳性率为100%,显著高于6岁以上各组(均P<0.05);且15～17岁组及成人组睡眠期手指征阳性率均为0%。各组睡眠期手指征阳性率均小于或等于睡眠期Babinski征阳性率,且睡眠期手指征阳性者睡眠期Babinski征亦为阳性。Spearman相关分析显示,睡眠期Babinski征阳性率及睡眠期手指征阳性率均与年龄呈负相关(r=-0.501,P<0.01;r=-0.985,P<0.01)。结论正常人睡眠中出现阳性Babinski征和手指征可能与锥体束受到抑制有关。睡眠时锥体束抑制随年龄增长而减弱,且支配上肢的锥体束受睡眠抑制比支配下肢的锥体束要难。

抑郁症患者可乐定快速眼运动睡眠抑制试验的对照研究

目的 探讨重性抑郁症患者α2 肾上腺能受体功能状况。方法 对 15例重性抑郁症患者 (抑郁症组 )和 15名正常人 (正常对照组 )分别进行多导睡眠脑电图检查。在第 1个快速眼运动(REM)睡眠周期结束 10min内 ,向所有被试者静脉注射可乐定 (剂量按 2mg/kg体重计算 ,并稀释于 9ml生理盐水中 ) ,比较两组的睡眠情况。结果 可乐定注射前 ,抑郁症组的REM比例 [(2 6 8±5 6 ) % ]、REM次数 [(6 8± 1 2 )次 ]及REM时间 [(12 0 6± 2 5 1)min]较正常对照组增加 [分别为(19 2± 3 3) %、(4 9± 0 8)次、(78 8± 14 4)min ;P <0 0 5 ],REM潜伏期缩短 [(6 4 1± 2 7 0 )min ,对照组为 (96 1± 2 7 0 )min];可乐定注射后 ,对两组非快速眼运动睡眠几乎无影响 ,而抑郁症组和对照组的REM比例 [分别为 (2 1 3± 4 8) %和 (13 6± 2 7) % ]、次数 [分别为 (5 3± 1 2 )次和 (3 8± 0 6 )次 ]、时间[(10 1 0± 2 4 0 )min和 (6 1 0± 10 3)min]分别较注射前减少 (P <0 0 5 ) ,抑郁症组第 1次和第 2次REM间隔时间的差值小于正常对照组 (P <0 0 1) ;而两组REM潜伏期注射前后的差异均无显著性。提示抑郁症患者REM睡眠的可乐定反映较正常对照组迟钝。结论 重性抑郁症患者可能存在α2 肾上腺能受体功能低下。

Inhibiting effects of low-molecular weight heparin and adrenocortical hormone on hemolysis of red cells in patients with paroxysmal nocturnal hemoglobinuria in vitro

OBJECTIVE: To study the effects of low-molecular weight heparin (LMWH) and adrenocortical hormone (dexamethasone) on the hemolysis of red cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) in vitro. METHODS: Using Ham's test and micro-complement lysis sensitive test (mCLST), the changes in hemolysis of red cells from 6 typical PNH cases were examined after adding LMWH and dexamethasone in different concentrations into the test solution in vitro. The effects of LMWH and dexamethasone on the coagulation of the tested blood samples were also studied using the activated partial thromboplastin time (APTT) test. RESULTS: Both LMWH and dexamethasone inhibited the hemolysis of PNH red cells, and they also showed a synergistic effect. The inhibiting effects were dose-dependent. Moreover, a tolerable dose of LMWH induced a limited prolongation of APTT. Dexamethasone showed two possible mechanisms in the inhibition of PNH red cells hemolysis through Ham's test and mCLST, respectively: (1) inhibiting both antibodies binding to red cells and (2) the initiation of the activation of complement 3 (C3). LMWH could inhibit hemolysis as determined by both Ham's test and mCLST, which indicated that LMWH could block the activation of complement cascade. CONCLUSIONS: Both LMWH and dexamethasone could inhibit hemolysis in PNH, and they showed a synergistic effect. Their mechanisms of inhibiting hemolysis differed from each other. Furthermore, a tolerable dose of LMWH induced a limited prolongation of APTT. LMWH might be useful for controlling acute hemolysis in patients with PNH and reducing the dose of adrenocortical hormone.