摘要目的 观察选择性5-羟色胺再摄取抑制剂(SSRIs)对抑郁症患者的快动眼(REM)睡眠肌张力的影响.方法 选择年龄和性别匹配的接受SSRIs治疗的抑郁患者(治疗组,21例)、未接受SSRIs治疗的抑郁患者(未治疗组,21例)和正常对照组(21例),根据Lapierre和Montplaisir的标准重新评估每组患者每个REM睡眠包含的张力性和位相性肌电活动.结果 (1)REM睡眠张力性:治疗组[(10.1±9.4)%]与未治疗组[(3.3±3.7)%]和正常对照组[(2.8±3.4)%]比较,REM睡眠张力性增加,差异有统计学意义(P＜0.001).(2)位相性肌电活动:治疗组[(11.5±6.8)%]与未治疗组[(6.3±4.1)%]和正常对照组[(5.0±3.7)%]比较,颌肌位相性肌电活动增加,差异有统计学意义(P＜0.05);治疗组[(18.8±13.2)%]与未治疗组[(10.3±7.2)%]和正常对照组[(9.8±5.5)%]比较,胫骨前肌位相性肌电活动增加,差异有统计学意义(P＜0.05).(3)治疗组REM睡眠的张力性和位相性肌电活动均与REM潜伏期呈正相关(γ=4.475,γ=0.397,γ=0.402),与REM比例呈负相关(γ=-0.353,γ=-0.511,γ=-0.463).结论 SSRIs阻碍了抑郁症患者REM睡眠肌张力消失.

abstractsObjective To investigate the effects of selective serotonin reuptake inhibitors (SSRIs)on the muscle tone during rapid eye movement (REM) sleep in depressive patients. Methods Twenty-one depressive patients in SSRIs treatment were recruited from the polysomnography database. And 21 depressive patients without any pharmacological treatment and 21 normal controls were recruited at the same time. According to Lapierre & Montplaisir criteria, the tonic and phasic electromyography (EMG) in REM sleep was reevaluated. Results Compared to no treatment group and normal control group, SSRIs group experienced more tonic EMG [ ( 10.1 ± 9.4) % vs. (3.3 ± 3.7) % & (2.8 ± 3.4) %, P ＜ 0.001 ] and phasic EMG [submental: (11.5 ± 6.8)% vs. (6.3 ± 4.1)% & (5.0 ± 3.7)%, P＜0.05, anterior tibialis: (18.8 ± 13.2)% vs. (10.3 ± 7.2)% & (9.8 ± 5.5)%, P＜0.05] in REM sleep. In SSRIs group, both tonic and phasic EMG in REM sleep correlated with REM latency positively (γ=4.475, γ=0.397 ,γ=0.402) and correlated with percentage of REM sleep negatively (γ= -0.353,γ=-0. 511 ,γ= -0.463 ). Conclusion SSRIs could increase EMG activity in REM sleep, mainly according to the mechanism of increasing serotonin.