李巍峰 张晓钰

[摘要] 目的 研究脑干卒中后低氧血症患者单胺类递质变化情况与卒中后睡眠障碍的相关性。方法 回顾性分析我院2018年5月至2021年1月收治的53例脑干卒中后低氧血症患者血浆单胺类递质及多导睡眠图与健康对照组的临床资料，进行研究组单胺类神经递质与睡眠参数相关性分析。 结果 研究组血清中去甲肾上腺素（NE）、多巴胺（DA）、5-羟吲哚乙酸（5-HIAA）、5-羟色胺（5-HT）低于对照组，差异有统计学意义（P<0.05）;研究组睡眠潜伏期（SL）长于对照组，快速动眼期（REMT）短于对照组，及REM潜伏期百分比（REML）低于对照组，差异有统计学意义（P<0.05）;去甲肾上腺素（NE）和5-羟色胺（5-HT）与睡眠障碍呈正相关。 结论 脑干卒中后低氧血症患者单胺类神经递质降低，患者睡眠障碍情况与单胺类神经递质变化具有相关性。

[关键词] 脑干卒中;低血氧症;单胺类递质;睡眠

[中图分类号] R743.3          [文献标识码] B          [文章編号] 1673-9701（2021）36-0045-04

Analysis of the relationship between the changes of monoamine neurotransmitters and sleep disorders after stroke in patients with hypoxemia after brainstem stroke

LI Weifeng1   ZHANG Xiaoyu2

1.Department of Neurology， People′s Hospital of Rongcheng in Shandong Province， Rongcheng   264300， China; 2.Department of Neurology， Capital Medical University School of Rehabilitation Medicine， Beijing Bo′ai Hospital， China Rehabilitation Research Center， Beijing   100068， China

[Abstract] Objective To study the correlation between the changes of monoamine neurotransmitters and sleep disorders after stroke in patients with hypoxemia after brainstem stroke. Methods The clinical data of plasma monoamine transmitters and polysomnography in 53 patients with hypoxemia after brainstem stroke admitted to our hospital from May 2018 to January 2021 and healthy controls were retrospectively analyzed. The correlation between monoamine neurotransmitters and sleep parameters was analyzed. Results The serum norepinephrine （NE）， dopamine （DA）， 5-hydroxyindoleacetic acid （5-HIAA）， and serotonin （5-HT） in the study group were lower than those in the control group， and the differences were statistically significant （P<0.05）. The sleep latency （SL） in the study group was longer than that in the control group. The rapid eye movement （REMT） in the study group was shorter than that in the control group， and REM latency percentage （REML） in the study group were lower than those in the control group， with statistical significance （P<0.05）. Norepinephrine （NE） and serotonin （5-HT） showed a positive correlation with sleep disorders. Conclusion Monoamine neurotransmitters are decreased in patients with hypoxemia after brainstem stroke， and sleep disturbance is correlated with monoamine neurotransmitter changes.

[Key words] Brainstem stroke; Hypoxemia; Monoamine transmitters; Sleep

脑干卒中作为脑血管疾病中的危重病，具有发病急、致死致残率高的特点[1]，随着我国人口老龄化的加快，脑干卒中发病率呈上升趋势[2]。脑干卒中发病后，易导致呼吸中枢性抑制，分泌物、呕吐物等误吸将影响患者肺通气功能，手术治疗中易对患者脑组织、神经系统造成损伤[3]， 使血液含氧量、肺泡氧分压（Alveolar oxygen partial pressure，PaO2）降低，引起低氧血症，严重危及患者生命[4]。脑干卒中后低氧血症可诱发心率失常、意识障碍等，睡眠障碍也是脑干卒中后低氧血症患者较常见的临床症状，相关研究表明，卒中后单胺类神经递质变化与睡眠障碍具有一定相关性[5]。……