双相障碍缓解期患者生物节律和睡眠模式特征的对照研究

发布时间：2018-11-15 07:46

【摘要】：目的：研究昼夜生物节律(CR)和睡眠模式特征在双相障碍（BD）缓解期患者与正常对照者中的不同特征，探讨昼夜生物节律与睡眠模式是否为双相障碍缓解期特征性指标。方法：通过严格的结构化临床会晤，根据《精神障碍诊断与统计手册（第四版）》（DSM-IV）中关于双相障碍Ⅰ型的诊断标准，筛选BD患者20例和年龄、性别匹配对照者20例，采用汉密尔顿抑郁量表（HAMD）、Bech-Rafaelsen躁狂量表（BRMS）、状态-特质焦虑量表（STAI）、匹兹堡睡眠质量指数问卷（PSQI）、筛查所有受试者的情绪、睡眠状况，并进行连续1周Actigraph体动监测，使用ActiLife5.6.4软件分析受试者活动量、活动节律以及睡眠状况。采用SPSS16.0统计分析软件对研究数据进行分析。结果：1、病例组与对照组每天单位体重活动耗能（kcal/kg）（3.325±1.193v.s.4.243±0.7611，p=0.001）、活动分级比例（%）（静坐级：77.71±6.99v.s.69.99±6.71，p=0.001；轻度级：2.69±2.02v.s.7.84±3.35，p=0.000；中度级：0.02±0.03v.s.0.68±0.99，p=0.004）存显著性差异。2、病例组与对照组工作日和周末活动量分级自身比较不具统计学差异。3、病例组与对照组日间稳定性（IS）比较不具统计学差异（p=0.06）；昼夜变异性（IV）比较具有统计学差异（p=0.002）。4、病例组和对照组睡眠参数比较不具有统计学差异，对照组中周末比工作日总睡眠时间长（p=0.004）。结论：双相障碍缓解期患者仍然具有明显的活动量、活动节律的改变。提示双相障碍缓解期患者仍然具有生物节律的紊乱。生物节律变化独立双相障碍的其他症状，，可能是双相障碍病程中病情缓解复发的有效生物学指标。
[Abstract]:Aim: to study the different characteristics of circadian biological rhythm (CR) and sleep pattern in patients with bipolar disorder (BD) in remission period and in normal controls, and to explore whether circadian biological rhythm and sleep pattern are characteristic indexes of bipolar disorder remission. Methods: 20 patients with BD and 20 matched controls with age and sex were selected according to the criteria of bipolar disorder type I in the Diagnostic and Statistical Manual for Mental Disorder (fourth Edition) (DSM-IV). The Hamilton Depression scale (HAMD), Bech-Rafaelsen), the (BRMS), mania scale (BRMS), the Pittsburgh Sleep quality Index (STAI),) and the Pittsburgh Sleep quality Index (PSQI),) were used to screen the mood and sleep status of all subjects. The body movement of Actigraph was monitored for 1 week, and the activity, rhythm and sleep status of subjects were analyzed by ActiLife5.6.4 software. SPSS16.0 statistical analysis software was used to analyze the research data. Results: 1. The activity energy consumption (kcal/kg) per unit body weight was (3.325 卤1.193v.s.4.243 卤0.7611) per day and the activity grading ratio (%) in the case group and the control group was 77.71 卤6.99v.s.69.99 卤6.71, respectively. P0. 001; Mild grade: 2.69 卤2.02v.s.7.84 卤3.35 p0. 000; Moderate grade: 0.02 卤0.03v.s.0.68 卤0.99p 0.004). 2There was no significant difference in the activity levels between the case group and the control group on weekdays and weekends. There was no significant difference in day stability (IS) between the case group and the control group (p0. 06). The diurnal variability of (IV) was statistically different (p0. 002). 4. There was no significant difference in sleep parameters between the case group and the control group, and the total sleep time in the control group was longer than that in the working day (p0. 004). Conclusion: the patients with bipolar disorder still have significant changes in activity volume and activity rhythm. The results suggest that the patients with bipolar disorder still have the disorder of biological rhythm. Other symptoms of biphasic disorder may be an effective biological index for remission and recurrence of biphasic disorder in the course of bipolar disorder.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.4

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