本文選題：日間過度嗜睡 + 中樞性睡眠增多��； 參考：《吉林大學》2017年碩士論文

【摘要】：目的:本研究旨在明確中樞性睡眠增多患者動態(tài)腦血流自動調(diào)節(jié)的變化,并探討其可能作用的病理生理機制,為指導臨床治療提供更多依據(jù)。方法:本研究選取2016年2月到2017年2月期間就診于吉林大學第一醫(yī)院神經(jīng)內(nèi)科門診的符合日間過度嗜睡的診斷標準的研究對象21例及健康對照組7例,根據(jù)夜間睡眠監(jiān)測加多次睡眠潛伏期試驗檢查結(jié)果將實驗組分為嗜睡組7例、發(fā)作性睡病不伴RBD組7例、發(fā)作性睡病伴RBD組7例。應用經(jīng)顱多普勒超聲聯(lián)合連續(xù)指尖血壓檢測儀,無創(chuàng)地同步記錄腦血流速度(CBFV)和動脈血壓,采用目前公認的傳遞函數(shù)分析(TFA)方法計算導出腦血流自動調(diào)節(jié)參數(shù):相位差(PD)、增益、相關性,評價腦血流自動調(diào)節(jié)功能。在發(fā)作性睡病患者中,有7例經(jīng)過至少1個月規(guī)范治療后再次行腦血流調(diào)節(jié)檢查,并與治療前進行比較。結(jié)果:(1)嗜睡組、發(fā)作性睡病不伴RBD組、發(fā)作性睡病伴RBD組ESS(14.6±3.8、16.4±4.0、18.0±2.9)與對照組數(shù)值(2.1±1.3)比較均明顯升高,差異均有統(tǒng)計學意義(p0.05)。嗜睡組、發(fā)作性睡病不伴RBD組、發(fā)作性睡病伴RBD組左相位差(33.97±8.71、35.49±11.72、32.00±13.09)與對照組數(shù)值(53.15±7.91)比較均明顯下降;嗜睡組、發(fā)作性睡病不伴RBD組、發(fā)作性睡病伴RBD組右相位差(33.95±9.21、36.58±13.30、31.85±8.77)與對照組數(shù)值(53.54±10.87)比較均明顯下降,不同組別研究對象的左右相位差差異均有統(tǒng)計學意義(p0.05)。不同組別研究對象的左右增益差異均無統(tǒng)計學意義(p0.05)。發(fā)作性睡病伴RBD與不伴RBD相應半球的相位差、增益相比,差異均無統(tǒng)計學意義(p0.05)。(2)發(fā)作性睡病治療前后相比,治療后ESS(11.3±2.0)較治療前ESS(15.6±2.7)降低,其差異具有統(tǒng)計學意義(p0.05);治療后左側(cè)PD(43.9±12.54°)與治療前左側(cè)PD(24.79±10.13°)相比,PD差異顯著增加,差異具有顯著統(tǒng)計學意義(p0.05)。治療后右側(cè)PD(43.05±14.89°),與治療前左側(cè)PD(25.39±5.50°)相比,PD差異顯著增加,具有統(tǒng)計學意義(p0.05),而治療前后的左右增益差異均無統(tǒng)計學意義(p0.05)。結(jié)論:(1)中樞性睡眠增多患者的動態(tài)腦血流自動調(diào)節(jié)功能受損。(2)對于發(fā)作性睡病伴RBD與不伴RBD的患者,動態(tài)腦血流自動調(diào)節(jié)功能受損程度無差異,可能有相同的病理生理機制有關。(3)經(jīng)藥物(哌甲酯、氟西汀或文拉法辛)治療后發(fā)作性睡病患者的動態(tài)腦血流自動調(diào)節(jié)功能有所改善。
[Abstract]:Objective: to investigate the changes of dynamic cerebral blood flow automatic regulation in patients with central sleepiness and to explore the pathophysiological mechanism of its possible role in order to provide more evidences for clinical treatment. Methods: from February 2016 to February 2017, 21 subjects who met the diagnostic criteria of daytime excessive somnolence in the Department of Neurology, first Hospital of Jilin University, and 7 healthy controls were selected. According to the results of nocturnal sleep monitoring and multiple sleep latency test, the experimental group was divided into narcolepsy group (n = 7), narcolepsy without RBD group (n = 7) and narcolepsy with RBD group (n = 7). The cerebral blood flow velocity (CBFV) and arterial blood pressure were recorded noninvasively by transcranial Doppler ultrasound combined with continuous fingertip blood pressure detector. The parameters of automatic cerebral blood flow regulation were calculated and derived by using the currently accepted transfer function analysis (TFAA) method: phase difference PDV, gain, and so on. To evaluate the function of cerebral blood flow automatic regulation. Among the patients with paroxysmal narcolepsy, 7 patients underwent cerebral blood flow regulation after at least one month of standardized treatment, and were compared with those before treatment. Results compared with the control group, the contents of ESS(14.6 鹵3.8N 16.4 鹵4.0 鹵18.0 鹵2.9 in narcolepsy group, paroxysmal sleepiness group without RBD and paroxysmal sleep disease with RBD group were significantly higher than those in control group (2.1 鹵1.3). The difference was statistically significant (P 0.05). In narcolepsy group, the left phase difference of narcolepsy without RBD and paroxysmal sleep with RBD was 33.97 鹵8.71 鹵35.49 鹵11.72 鹵32.00 鹵13.09) significantly lower than that of control group (53.15 鹵7.91), while in narcolepsy group, paroxysmal sleepiness was not associated with RBD. The right phase difference (33.95 鹵9.21 鹵36.58 鹵13.30 鹵31.85 鹵8.77) in paroxysmal sleepiness with RBD group was significantly lower than that in control group (53.54 鹵10.87). There was no significant difference in left and right gain between different groups of subjects (p 0.05). There was no significant difference in the phase difference and gain between paroxysmal sleepiness with RBD and those without RBD. There was no significant difference between the two hemispheres before and after treatment. Compared with before and after treatment, ESS(11.3 鹵2.0) was significantly lower than that before and after treatment (ESS(15.6 鹵2.7). The difference of PD between left PD(43.9 鹵12.54 擄and left PD(24.79 鹵10.13 擄after treatment was significantly higher than that before treatment, and the difference was statistically significant (P 0.05). After treatment, the right PD(43.05 鹵14.89 擄PD(43.05 was significantly higher than that of the left side PD(25.39 鹵5.50 擄(P 0.05), but there was no significant difference in left and right gain before and after treatment. Conclusion (1) there is no difference in the degree of impairment of dynamic cerebral blood flow automatic regulation between patients with paroxysmal sleepiness with RBD and those without RBD. There may be the same pathophysiological mechanism related to .t3) the automatic regulation of dynamic cerebral blood flow in patients with narcolepsy was improved after treatment with drugs (methylphenidate, fluoxetine or venlafaxine).
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R740

【相似文獻】

相關期刊論文 前10條

1 龔浠平;王擁軍;;腦血流自動調(diào)節(jié)測定的應用[J];中國臨床康復;2006年30期

2 江蓮,龐素華,劉定華;慢性肺心病呼吸衰竭患者腦血流自動調(diào)節(jié)功能的觀察[J];江蘇醫(yī)藥;1999年03期

3 王盛章;姚偉;丁光宏;;腦血流自動調(diào)節(jié)功能的五單元模型[J];生物醫(yī)學工程學雜志;2009年05期

4 申英霞;王月榮;劉躍雷;;基于非線性動力學的腦血流自動調(diào)節(jié)能力評估[J];微計算機信息;2010年10期

5 王坤;王文明;;腦血流自動調(diào)節(jié)功能的研究進展[J];濟寧醫(yī)學院學報;2011年02期

6 殷彬;腦血流自動調(diào)節(jié)及其在精神科的研究進展[J];國外醫(yī)學.精神病學分冊;1998年04期

7 高慶春,陳秀梅,陳穎賢,黃如訓;腦血管對二氧化碳反應過程中腦血流自動調(diào)節(jié)功能的變化[J];中華醫(yī)學雜志;2005年22期

8 顧正中,石中瑗,王利華,王金根;急性低氧條件下腦血流的自動調(diào)節(jié)[J];科學通報;1983年17期

9 呂存玲;楊弋;郭珍妮;邢英琦;;腦血流自動調(diào)節(jié)功能在卒中應用的研究進展[J];中國卒中雜志;2014年03期

10 高慶春,黃如訓,曾進勝,蘇鎮(zhèn)培,陳穎賢,陳鍵文;經(jīng)顱多普勒超聲檢測腦血流自動調(diào)節(jié)下限的初步應用[J];中華超聲影像學雜志;2001年05期

相關會議論文 前3條

1 黃家星;;急性缺血性腦血管病腦血流自動調(diào)節(jié)的研究[A];第十一屆全國神經(jīng)病學學術會議論文匯編[C];2008年

2 高慶春;邵延芹;陳穎賢;黃如訓;;試驗性高血壓對腦血流自動調(diào)節(jié)功能影響的動態(tài)觀察[A];中華醫(yī)學會第七次全國神經(jīng)病學學術會議論文匯編[C];2004年

3 朱良付;黃如訓;盛文利;高慶春;陳穎賢;蘇振培;劉春嶺;曾進勝;;無創(chuàng)測定高血壓者腦血流自動調(diào)節(jié)下限及臨界關閉壓變化率[A];第九次全國神經(jīng)病學學術大會論文匯編[C];2006年

相關博士學位論文 前1條

1 鄭躍英;連續(xù)無創(chuàng)腦血流自動調(diào)節(jié)監(jiān)測在成人圍手術期的應用研究[D];浙江大學;2015年

相關碩士學位論文 前10條

1 申英霞;腦血流自動調(diào)節(jié)能力評估的研究[D];蘭州大學;2009年

2 鄔學聰;腦血流自動調(diào)節(jié)能力評估關鍵算法及下肢束帶平臺研究[D];哈爾濱工業(yè)大學;2015年

3 馬虹印;腦出血患者的動態(tài)腦血流自動調(diào)節(jié)時程變化特點的研究[D];吉林大學;2016年

4 張然;中樞性睡眠增多患者的動態(tài)腦血流自動調(diào)節(jié)的研究[D];吉林大學;2017年

5 趙韌;急性腦梗死患者動態(tài)腦血流自動調(diào)節(jié)功能受損的相關危險因素研究[D];吉林大學;2017年

6 趙璐;廣泛性焦慮障礙與腦血流自動調(diào)節(jié)關系的研究[D];吉林大學;2017年

7 儲霞;腦血流自動調(diào)節(jié)機能動態(tài)檢測方法研究[D];華南理工大學;2010年

8 陸雯;動態(tài)腦血流自動調(diào)節(jié)能力檢測系統(tǒng)的研究[D];云南大學;2011年

9 閆碩;不同亞型急性缺血性卒中的動態(tài)腦血流自動調(diào)節(jié)的研究[D];吉林大學;2014年

10 楊樂;腦血流自動調(diào)節(jié)與焦慮癥相關性研究[D];吉林大學;2013年

，

本文編號：1925960