【摘要】 目的 探讨多导睡眠监测(PSG)在失眠症的诊断与调整右佐匹克隆药物剂量中的应用价值与疗效分析。方法 采用回顾性调查的方式收集2019年12月以前收治的失眠症住院患者73例作为对照组，将2020年1月～2021年12月期间收治的75例失眠症住院患者设为研究组。对照组采用右佐匹克隆治疗，研究组根据PSG结果(治疗前及治疗后第2、4周末)动态调整右佐匹克隆药物剂量，两组疗程均为4周。患者睡眠质量采用匹兹堡睡眠质量指数量表(PSQI)和睡眠状况自评量表(SRSS)进行评价；并比较药物不良反应、药物依赖和治疗时间以评价临床疗效。6个月随访疾病复发率及SRSS、PSQI等量化指标并结合动态PSG综合分析其在失眠症的诊断与调整右佐匹克隆药物剂量中的应用价值。结果 研究组总有效率高于对照组(P<0.05)。两组治疗后第2、4周末和6个月随访时SRSS和PSQI评分均较治疗前下降(P<0.05)。研究组治疗后第4周末和6个月随访时SRSS和PSQI评分均低于对照组(P<0.05)。研究组治疗后第4周末和6个月随访时觉醒总时间、醒觉次数、睡眠潜伏期(SL)、睡眠N1%、N2%、N3期δ波数量和δ波密度均低于对照组(P<0.05),睡眠总时间(TST)、N3%、快速动眼期(REM)和睡眠效率(SE)均高于对照组(P<0.05)。PSG监测结果发现，研究组治疗后第4周末和6个月随访时SL≥30min、醒觉次数≥2次和TST<6.5 h例数所占百分比低于对照组(P<0.05)。治疗后研究组头痛、头晕、视线模糊、嗜睡、乏力不良反应发生率均少于对照组(P<0.05),6个月随访时研究组复发率、药物依赖性和平均治疗时间均少于对照组(P<0.05)。结论 PSG对失眠症的诊断和右佐匹克隆调整有较高的参考价值，根据动态PSG调整右佐匹克隆药物剂量可提高失眠症临床疗效、降低药物不良反应、减少药物依赖性并缩短治疗时间。更多还原

【Abstract】 Objective To explore the application value and efficacy analysis of polysomnography（PSG） in the diagnosis of insomnia and adjustment of the dose of eszopiclone. Methods In this study, a retrospective survey was used to collect 73 inpatients with insomnia who were admitted before December 2019 as control group, and 75 inpatients with insomnia admitted from January 2020 to December 2021 were selected as study group. The control group was treated with eszopiclone; the study group was dynamically adjusted the dose of eszopiclone according to the PSG results(before treatment, and at the 2^nd and 4^th weekends after treatment), and the course of treatment in both groups was 4 weeks. The sleep quality of patients was evaluated by Pittsburgh Sleep Quality Index（PSQI） and Self-Rating Scale of Sleep（SRSS）, and to evaluate clinical efficacy through comparing drug side effects, drug dependence and treatment time. 6-month follow-up of disease recurrence and quantitative indicators such as SRSS and PSQI combined with dynamic PSG were used to comprehensively analyze its application value in the diagnosis of insomnia and adjustment of eszopiclone drug dose. Results The total effective rate in study group was higher than that in control group（P<0.05）. At the ends of 2^nd,4^th weeks after treatment and 6-month follow-up, the total scores of SRSS and PSQI in both groups decreased significantly compared with those before treatment respectively（P<0.05）; and at the ends of 4^th week after treatment and 6-month follow-up, the total scores of SRSS and PSQI in study group were significantly lower than those in control group（P<0.05）. At the ends of 4^th week after treatment and 6-month follow-up, the total awakening time, numbers of awakenings, sleep latencies（SL）, sleep N1%, N2%, N3 phase delta wave numbers and delta wave densities in study group were significantly lower than those in control group（P<0.05）, and the total sleep time（TST）, N3%, rapid eye movements（REM） and sleep efficiencies（SE） in study group were significantly higher than those in control group（P<0.05）. At the ends of 4^th week after treatment and 6-month follow-up, the percentages of cases with SL≥30 min, times of awakening≥2 times and TST<6.5 h in study group were lower than those in control group（P<0.05）. After treatment, the incidence rates of adverse reactions such as headache, dizziness, blurred vision, drowsiness and fatigue in study group were significantly lower than those in control group（P<0.05）. After 6-month follow-up, the recurrence rate, drug dependence and average treatment time in study group were all lower or shorter than those in control group（P<0.05）. Conclusion PSG has a high reference value for the diagnosis of insomnia and adjustment of eszopiclone. Adjusting the dose of eszopiclone according to dynamic PSG can improve the clinical efficacy of insomnia, reduce drug side effects and drug dependence as well as shorten the treatment time.更多还原