165例发作性睡病患者的临床特征分析
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摘要
目的研究分析山东省立医院睡眠医学中心确诊的165例发作性睡病患者的临床特征,提高临床医师对发作性睡病的认识。方法选取2015年1月至2018年8月我院睡眠医学中心诊治的165例发作性睡病患者的临床资料,进行回顾性分析。结果 165例发作性睡病患者中男性为女性的2.3倍,伴猝倒的患者占84.24%,高于既往研究;患者大部分来自于山东省,以八月、二月、三月就诊者最多;发病年龄、五联征发生概率及其他临床表现与既往研究基本相同。结论发作性睡病是一种相对罕见的神经系统疾病,发病早,临床表现多种多样,病因不明。应尽早诊断、治疗,并加强对患者的管理教育,以提高其生活质量。
Objective The clinical features of 165 patients with narcolepsy diagnosed in the sleep medicine center of Shandong Provincial Hospital to improve clinical physicians' understanding of narcolepsy.Methods To study the clinical data of 165 patients with narcolepsy who were diagnosed and treated in the sleep medicine center of our hospital from January 2015 to August 2018 were analyzed retrospectively.Results In 165 cases of narcolepsy,the number of man was 2.3times higher than that of woman and patients with cataplexy accounted for 84.24%,which were more than that of previous studies.Most of the patients were from Shandong province,and most were diagnosed in August,February and March.Age of onset,incidence rate of the syndrome pentad of narcolepsy and other clinical manifestations were basically the same as those of the previous studies.Conclusion Narcolepsy is a relatively rare nervous system disease,whose onset is accompanied with diverse clinical manifestations and unknown etiology.Early diagnosis,treatment and management of patients should be strengthened to improve their quality of life.
Objective The clinical features of 165 patients with narcolepsy diagnosed in the sleep medicine center of Shandong Provincial Hospital to improve clinical physicians' understanding of narcolepsy.Methods To study the clinical data of 165 patients with narcolepsy who were diagnosed and treated in the sleep medicine center of our hospital from January 2015 to August 2018 were analyzed retrospectively.Results In 165 cases of narcolepsy,the number of man was 2.3times higher than that of woman and patients with cataplexy accounted for 84.24%,which were more than that of previous studies.Most of the patients were from Shandong province,and most were diagnosed in August,February and March.Age of onset,incidence rate of the syndrome pentad of narcolepsy and other clinical manifestations were basically the same as those of the previous studies.Conclusion Narcolepsy is a relatively rare nervous system disease,whose onset is accompanied with diverse clinical manifestations and unknown etiology.Early diagnosis,treatment and management of patients should be strengthened to improve their quality of life.
引文
[1] Billiard M,Cadilhac J.Narcolepsy[J].Rev Neurol(Paris),1985,141(8-9):515-527.
[2] AmericanAcademyofSleepMedicine. International classification of sleep disorders[M].3rd ed.Darien:American Academy of Sleep Medicine,2014:143-161.
[3]中华医学会神经病学分会,中华医学会神经病学分会睡眠障碍学组,解放军医学科学技术委员会神经内科专业委员会睡眠障碍学组.中国发作性睡病诊断与治疗指南[J].中华神经科杂志,2015,48(6):445-452.
[4] Akintomide GS, Rickards H.Narcolepsy:a review[J].Neuropsychiatr Dis Treat,2011,7:507-518.
[5] Klimova B,Maresova P,Novotny M,et al.A global view on narcolepsy-a review study[J].Mini Rev Med Chem,2018,18(5):458-464.
[6] Wing YK,Li RH,Lam CW,et al.The prevalence of narcolepsy among Chinese in Hong Kong[J].Ann Neurol,2002,51(5):578-584.
[7] Wu H,Zhuang J,Stone WS,et al.Symptoms and occurrences of narcolepsy:a retrospective study of 162patients during a10-years period in eastern China[J].Sleep Med,2014,15(6):607-613.
[8] Mignot E.Genetic and familial aspects of narcolepsy[J].Neurology,1998,50(2Suppl 1):S16-22.
[9] Han F, Lin L, Li J,et al.Presentations of primary hypersomnia in Chinese children[J].Sleep,2011,34(5):627-632.
[10] Longstreth WT Jr, Koepsell TD, Ton TG,et al.The epidemiology of narcolepsy[J].Sleep,2007,30(1):13-26.
[11] Won C,Mahmoudi M,Qin L,et al.The impact of gender on timeliness of narcolepsy diagnosis[J].J Clin Sleep Med,2014,10(1):89-95.
[12] Leschziner G.Narcolepsy:a clinical review[J].Pract Neurol,2014,14(5):323-331.
[13] Thorpy MJ,Dauvilliers Y.Clinical and practical considerations in the pharmacologic management of narcolepsy[J].Sleep Med,2015,16(1):9-18.
[14] Benca RM.Narcolepsy and excessive daytime sleepiness diagnostic considerations,epidemiology,and comorbidities[J].J Clin Psychiatry,2007,68(Suppl 13):5-8.
[15] Dodel R,Peter H, Walbert T,et al.The socioeconomic impact of narcolepsy[J].Sleep,2004,27(6):1123-1128.
[16] Inocente CO,Gustin MP,Lavault S,et al.Quality of life in children with narcolepsy[J].CNS Neurosci Ther,2014,20(8):763-771.
[17] Daniels E,King MA,Smith IE,et al.Health-related quality of life in narcolepsy[J].J Sleep Res,2001,10(1):75-81.
[18] Flores NM,Villa KF,Black J,et al.The humanistic and economic burden of narcolepsy[J].J Clin Sleep Med,2016,12(3):401-407.
[19] Nordstrand SH,Hansen BH,Kamaleri Y,et al.Changes in quality of life in individuals with narcolepsy type 1after the H1N1-influenza epidemic andvaccinationcampaignin Norway:a two-year prospective cohort study[J].Sleep Med,2018,50:175-180.
[20]李强,刘诗翔.睡眠障碍的临床研究进展[J].疑难病杂志,2007,6(12):757-759.
[21] Billiard M,Bassetti C,Dauvilliers Y,et al.EFNS guidelines on management of narcolepsy[J].Eur J Neurol,2006,13(10):1035-1048.
[22] Nittur N,Konofal E,Dauvilliers Y,et al.Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants:a long-term chart review[J].Sleep Med,2013,14(1):30-36.
[23] Mignot EJ.A practical guide to the therapy of narcolepsy and hypersomnia syndromes[J].Neurotherapeutics,2012,9(4):739-752.
[24] Broderick M, Guilleminault C.Rebound cataplexy after withdraw from antidepressants[J].Sleep Med,2009,10(4):403-404.
[2] AmericanAcademyofSleepMedicine. International classification of sleep disorders[M].3rd ed.Darien:American Academy of Sleep Medicine,2014:143-161.
[3]中华医学会神经病学分会,中华医学会神经病学分会睡眠障碍学组,解放军医学科学技术委员会神经内科专业委员会睡眠障碍学组.中国发作性睡病诊断与治疗指南[J].中华神经科杂志,2015,48(6):445-452.
[4] Akintomide GS, Rickards H.Narcolepsy:a review[J].Neuropsychiatr Dis Treat,2011,7:507-518.
[5] Klimova B,Maresova P,Novotny M,et al.A global view on narcolepsy-a review study[J].Mini Rev Med Chem,2018,18(5):458-464.
[6] Wing YK,Li RH,Lam CW,et al.The prevalence of narcolepsy among Chinese in Hong Kong[J].Ann Neurol,2002,51(5):578-584.
[7] Wu H,Zhuang J,Stone WS,et al.Symptoms and occurrences of narcolepsy:a retrospective study of 162patients during a10-years period in eastern China[J].Sleep Med,2014,15(6):607-613.
[8] Mignot E.Genetic and familial aspects of narcolepsy[J].Neurology,1998,50(2Suppl 1):S16-22.
[9] Han F, Lin L, Li J,et al.Presentations of primary hypersomnia in Chinese children[J].Sleep,2011,34(5):627-632.
[10] Longstreth WT Jr, Koepsell TD, Ton TG,et al.The epidemiology of narcolepsy[J].Sleep,2007,30(1):13-26.
[11] Won C,Mahmoudi M,Qin L,et al.The impact of gender on timeliness of narcolepsy diagnosis[J].J Clin Sleep Med,2014,10(1):89-95.
[12] Leschziner G.Narcolepsy:a clinical review[J].Pract Neurol,2014,14(5):323-331.
[13] Thorpy MJ,Dauvilliers Y.Clinical and practical considerations in the pharmacologic management of narcolepsy[J].Sleep Med,2015,16(1):9-18.
[14] Benca RM.Narcolepsy and excessive daytime sleepiness diagnostic considerations,epidemiology,and comorbidities[J].J Clin Psychiatry,2007,68(Suppl 13):5-8.
[15] Dodel R,Peter H, Walbert T,et al.The socioeconomic impact of narcolepsy[J].Sleep,2004,27(6):1123-1128.
[16] Inocente CO,Gustin MP,Lavault S,et al.Quality of life in children with narcolepsy[J].CNS Neurosci Ther,2014,20(8):763-771.
[17] Daniels E,King MA,Smith IE,et al.Health-related quality of life in narcolepsy[J].J Sleep Res,2001,10(1):75-81.
[18] Flores NM,Villa KF,Black J,et al.The humanistic and economic burden of narcolepsy[J].J Clin Sleep Med,2016,12(3):401-407.
[19] Nordstrand SH,Hansen BH,Kamaleri Y,et al.Changes in quality of life in individuals with narcolepsy type 1after the H1N1-influenza epidemic andvaccinationcampaignin Norway:a two-year prospective cohort study[J].Sleep Med,2018,50:175-180.
[20]李强,刘诗翔.睡眠障碍的临床研究进展[J].疑难病杂志,2007,6(12):757-759.
[21] Billiard M,Bassetti C,Dauvilliers Y,et al.EFNS guidelines on management of narcolepsy[J].Eur J Neurol,2006,13(10):1035-1048.
[22] Nittur N,Konofal E,Dauvilliers Y,et al.Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants:a long-term chart review[J].Sleep Med,2013,14(1):30-36.
[23] Mignot EJ.A practical guide to the therapy of narcolepsy and hypersomnia syndromes[J].Neurotherapeutics,2012,9(4):739-752.
[24] Broderick M, Guilleminault C.Rebound cataplexy after withdraw from antidepressants[J].Sleep Med,2009,10(4):403-404.