林冬梅,黄丽宏,孙旭,高得强,钟鑫,黄旭楠,冯潇
LIN Dongmei,HUANG Lihong,SUN Xu,GAO Deqiang,ZHONG Xin,HUANG Xunan,FENG Xiao

• 1:吉林省神经精神病医院心理睡眠调适中心

摘要(Abstract)：

目的:分析青少年抑郁症患者抑郁情绪及睡眠障碍情况。方法:选取81例青少年抑郁症患者作为研究组、并根据抑郁程度分为轻中度组(n=47)和重度组(n=34),另外选取50例同期体检的健康青少年作为对照组;采用汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数量表(PSQI)评分评估2组受试者及轻中度、重度组青少年抑郁症患者的抑郁情绪及睡眠障碍情况,采用Pearson法分析青少年抑郁症患者的HAMD、PSQI评分相关性;采用多导睡眠图监测系统监测2组受试者及轻中度组、重度组青少年抑郁症患者的总记录时间(TRT)、总睡眠时间(TST)、睡眠效率(SE)、睡眠潜伏期(SL)、快速眼动相睡眠(REM)潜伏期(RL)、醒觉次数(NW)、醒觉时间(AT),S1、S2、慢波睡眠(SWS)期的时间及占比,睡眠时间(RT)及占比、REM活动度(RA)、REM强度(RI)及REM密度(RD)。结果:与对照组比较,研究组HAMD及PSQI评分均明显升高(P <0.001),且青少年抑郁症重度组的HAMD及PSQI评分明显高于轻中度组(P <0.001); Pearson相关分析结果显示青少年抑郁症患者HAMD评分与PSQI评分呈正相关(r=0.705,P=0.008);多导睡眠图监测结果显示,与对照组比较,研究组TST、SE、RL降低,SL、AT、NW升高(P <0.05或P <0.001),睡眠结构相关指标NREM时相S2升高、SWS降低,REM时相RT、RI、RD升高,差异均有统计学意义(P <0.05或P <0.001);与轻中度组比较,重度组睡眠进程指标TST、SE、RL降低,SL、NW、AT升高,差异均有统计学意义(P <0.05);睡眠结构相关指标SWS降低,S2、RT、RI、RD升高,差异均有统计学意义(P <0.05或P <0.001)。结论:青少年抑郁症患者普遍存在睡眠障碍,且睡眠障碍与其病情呈正相关,而多导睡眠图监测能有效检测出其睡眠生理指标的紊乱。
Objective: To analyze depression mood and sleep disorder in adolescent patients with depression. Methods: 81 adolescent depression patients were selected as the study group and divided into mild to moderate group( n = 47) and severe group( n = 34) according to the degree of depression. In addition,50 healthy adolescents were selected as control group. The depression and sleep disorder were assessed by Hamilton Depression Scale( HAMD) score and Pittsburgh Sleep Quality Index( PSQI) score in 2 groups,mild-to-moderate and severe groups of adolescent depression patients. The Pearson method was used to analyze the correlation of HAMD and PSQI. The total recorded time( TRT),total sleep time( TST),sleep efficiency( SE),sleep latency( SL),REM sleep latency( RL),wake-up times( NW),wake-up time( AT),S1 time,S2 time and proportion of slow wave sleep( SWS) period,sleep time( RT) and proportion,REM activity( RA),REM intensity( RI) and REM density( RD) were monitored by polysomnography monitoring system in 2 groups,mild-to-moderate and severe groups of adolescent depression patients. Results: The HAMD score and PSQI score of the study group were higher than those of the control group( P < 0. 05). The HAMD score and PSQI score in the severe group were significantly higher than those in the mild-to-medium group( P < 0. 001). Pearson correlation analysis showed a positive correlation between HAMD and PSQI scores in adolescents with depression. The results of polysomnography showed that the TST,SE and RL of the study group was lower than that of the control group,and the SL,AT and NW was higher than that of the control group( P < 0. 05 or P < 0. 001); The relative indexes of sleep structure in the study group were significantly higher in NREM time phase S2,lower in SWS and higher in REM time phase RT,RI and RD; the differences were all statistically significant( P < 0. 05 or P < 0. 001).Compared with the mild-moderate group,the sleep process index TST,SE and RL were significantly decreased and the SL,NW and AT were significantly increased in the severe group,the differences were statistically significant( P < 0. 05). Compared with the mild-moderate group,the relative indexes of sleep structure SWS were significantly decreased and the S2,RT,RI and RD were significantly increased in the severe group,the difference was statistically significant( P < 0. 05 or P < 0. 001).Conclusion: Sleep disorder is common in adolescent depression patients and it is positively related to their disease conditions while polysomnography monitoring can effectively detect the disturbance of their sleep physiological indicators.

关键词(KeyWords)： 抑郁症;睡眠障碍;青少年;多导睡眠描记术;睡眠结构
depressive disorder;sleep disorders;adolescent;polysomnography;sleep structure

Abstract:

Keywords:

基金项目(Foundation): 吉林省卫生健康适宜技术推广项目(20195018)

作者(Author): 林冬梅,黄丽宏,孙旭,高得强,钟鑫,黄旭楠,冯潇
LIN Dongmei,HUANG Lihong,SUN Xu,GAO Deqiang,ZHONG Xin,HUANG Xunan,FENG Xiao

DOI: 10.19367/j.cnki.2096-8388.2020.08.020

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