目的:探究脑内多巴胺神经递质表达对神经内科住院患者睡眠障碍的影响。 方法:选取我院神经内科收治的34例睡眠障碍患者和同期30例志愿者作为研究对象,分别为观察组和对照组,64例入选人员均于2周前停止服用咖啡、酒等刺激性饮料,采用匹兹堡睡眠质量指数量表(PSQI)、汉密顿抑郁量表(HAMD)检测睡眠质量和抑郁程度,同时进行脑部MRI检查,2 d后进行PET/CT扫描11C-雷氯必利标记的脑内多巴胺神经递质与受体结合情况。采用SPSS分析多巴胺神经递质与睡眠障碍相关指标的相关性。 结果:观察组HAMD、PSQI评分均显著高于对照组,差异具有统计学意义(P<0.05)。PET/CT扫描11C-雷氯必利多分布于伏隔核、尾状核、壳核。观察组伏隔核、尾状核、壳核多巴胺结合力均显著低于对照组,差异具有统计学意义(P<0.05)。采用pearson相关性分析,观察组病程与伏隔核、尾状核、壳核呈负相关(r=-0.754、-0.717、-0.728,P<0.05),而HAMD、PSQI评分与伏隔核、尾状核、壳核无相关性(P>0.05)。 结论:睡眠障碍患者多巴胺受体结合降低,同时与睡眠障碍的病程相关,提示多巴胺表达水平降低和睡眠障碍具有临床意义。
Objective: To explore the effect of dopamine neurotransmitter expression on sleep disorders in neurological inpatients. Methods: 34 patients with sleep disorders and 30 volunteers from February 2018 to November 2018 in neurology department of our hospital were selected as the study subjects. They were the observation group and the control group. 64 participants stopped taking stimulating drinks such as coffee and alcohol two weeks ago. The sleep quality and depression were measured by Pittsburgh Sleep Quality Index (PSQI) and Hamilton Depression Scale (HAMD). Degree of depression was examined by brain MRI. Two days later, 11C-Raclopril labeled brain dopamine neurotransmitter binding to receptors was scanned by PET/CT. SPSS was used to analyze the correlation between dopamine neurotransmitters and sleep disorders. Results: The HAMD and PSQI scores of the observation group were significantly higher than those of the control group (P<0.05). On PET/CT scans, 11C-Raclopride was mostly located in nucleus dorsal caudate putamen, caudate nucleus and putamen. The dopamine binding ability of nucleus dorsal caudate putamen, caudate nucleus and putamen in the observation group was significantly lower than that in the control group (P< 0.05). Pearson correlation analysis showed that the course of disease in the observation group was negatively correlated with nucleus dorsal caudate putamen, caudate nucleus and putamen (r=-0.754,-0.717,-0.728;P< 0.05), while the scores of HAMD and PSQI were not correlated with nucleus dorsal caudate putamen, caudate nucleus and putamen (P> 0.05). Conclusion: The decrease of dopamine receptor binding in patients with sleep disorders is related to the course of sleep disorders, suggesting that the decrease of dopamine expression and sleep disorders have clinical significance.