【作者】 张磊；

【导师】 杨连平；

【作者基本信息】 山西医科大学 ， 口腔临床医学， 2017， 硕士

【摘要】 目的:为探究磨牙症的监测方法,运用非接触型无线传输监测系统,采集磨牙症患者睡眠状态下磨牙时下颌骨振动产生的生物信号,分析其特征及与睡眠周期的关系,为磨牙症启动及结束机理提供依据。方法:筛选符合标准的夜磨牙症受试者20例,应用非接触型无线传输监测系统连续监测3日,监测装置于受试者枕下采集磨牙时下颌骨振动的生物信号,经可折叠线缆与主体控制器连接,内部完成A/D转换成数字电信号,并进行数据储存,安装手机(Application APP)绑定设备蓝牙,完成监测设备的wifi配置,与云端建立链接,上传数据至手机及云端,电脑APP下载处理分析每日数据;监测的同时开启录音设备,采集受试者整夜睡眠时声音信号,分别提取同一时间相对应的磨牙声音信号及振动信号,作为声谱组及振动组,记录每日总磨牙时间、最长磨牙时间、整夜磨牙频率及睡眠周期,以声音信号为基准运用统计学方法验证该监测方法的稳定性及一致性。结果:1.获得受试者每晚睡眠状态下的原始波形曲线,依此设计滤波算法得到过滤处理后的磨牙波形曲线,分析整理得到整夜磨牙频率、磨牙时间、运动幅值;2.配对t检验分析:声谱组和振谱组受试者每日总磨牙时间及最长磨牙时间相比,两组间差异无统计学意义(P>0.05);3.声谱组和振谱组每日整夜磨牙频率相比无显著差异(p>0.05),两组具有较高的一致性;4.声谱组及振谱组3日的总磨牙时间及最长磨牙时间(各60对数据)配对t检验无统计学意义(p>0.05),且经一致性检验Bland-Altman分析:每组仅有2/(60)3.3%个点位于95%一致性界限外,两组具有较高的一致性;5.亦可分析出每晚睡眠状态下睡眠周期、心率及体动变化指示图,尚无规律可寻,有待于扩展病例继续深入研究;6.依据睡眠周期变化指示图,测得20例受试者每日磨牙事件主要集中于(Rapid eye movement REM)期及浅睡眠期。结论:1.非接触型磨牙症监测系统实现了磨牙信息的数字化表达与信息存储分析,携带便捷;2.针对睡眠状态下磨牙时下颌骨振动信号进行监测,为监测研究磨牙症的启动及结束机理提了提供了新的方法;3.与声音信号相比一致性较高,且二者的波性特征均表现为“双峰波”,说明本监测系统不仅提供了稳定的监测结果而且可靠性较大。更多还原

【Abstract】 Objective:The aim of this research was to explore the monitoring method of bruxism,the non-contact wireless transmission monitoring system was used to collection biological signal generated by mandibular molar vibration when patients with sleep bruxism under dormancy of night,to analyze the characteristics of biological singnals and relationship with the sleep cycle,to provide a method for exploring the start and end mechanism of sleep bruxism.Methods:A total of 20 patients with sleep bruxism was randomly enrolled in this research according to the inclusion criteria.We applied non-contact type wireless transmission monitoring system continuously monitoring for 3 days.The monitoring device was placed under the pillow of patients.The monitoring device connected by a folding cable with the main controller,through A/D converted into digital signal and stored in the flash memory.Then installed the APP of mobile phone to binding the Bluetooth equipment,completing the WiFi configuration,established a link with the cloud,eventually upload data to the mobile phone and cloud,analysis of daily data of mandibular motion in patients with sleep bruxism under molar.The sound signals of the subjects during the whole night sleep were recorded with a pen recorder equipment.Vibration equipment and recording devices were open at the same time,extracting molars voice signals and relatively molars vibration signals of subjects respectively and divided in two groups of the spectrum group and the vibration group.The total molar time,the longest molar time and the molar frequency were recorded.The reliability and validity of the monitoring method were validated by using the statistical method.Results:1.Computer showed the waveform characteristics of the original waveforms and the waveforms of the molars after filtering,Analysis of the frequency of the whole molar,molar time and movement amplitude;2.Analysis of paired t test,there were no significant difference in total molar time,the longest molar time and the sound signals every night of subject between the spectrum group and the vibration group(all P>0.05).3.there were no significant difference in molar frequency every night of subject between the spectrum group and the vibration group(all P>0.05).4.According to the Bland-Altman consistency test,each group has 60 group of data,the total molar time and the longest molar time for 3 days of the two groups were 2/(60)3.3% points outside the 95% limits of agreement respectively and analysis of paired t test(all P>0.05),the two groups have high consistency;5.There was no significant can be found after analysis of the sleep cycle,heart rate and body movement indicator map of every night,further study needs to be extended on the basis of expanded the sample size;6.Based on the sleep cycle change indicator map,the results showed that the daily bruxism events were mainly concentrated in the REM phase and the shallow sleep period.Conclusions:1.The no-contact type detection system realizes the collection and digital expression of biological signal,which was convenient to carry;2.To monitored the vibration of molar mandibular,for follow-up study of bruxism start and end of the mechanism to lay a good foundation;3.There was high consistency compared with the sound signal,and the two characteristics of the wave are shown as “double peak wave”,this monitoring system not only provides the stability of the monitoring results but also its reliability is bigger.更多还原