| Objective:To explore the Wilson's disease(WD)patients who were first admitted to the hospital and/or had long-term unregulated copper displacing therapy,Ambulatory electroencephalogram(AEEG)and polysomnogram(PSG)monitoring of WD heterozygote.The study investigated the differences between AEEG and PSG in patients with different clinical types of WD,WD heterozygote and normal controls to provide a more in-depth study of the relationship between AEEG and PSG changes and disease severity and clinical efficacy in WD patients.To determine the clinical prognosis provides the basis for the previous study.Method:1.Research objectWD patient group: A total of 175 WD patients who had been diagnosed with the first hospitalization and/or long-term untreated copper-dissolving therapy for the period from August 2016 to February 2018 for this study unit were divided into three groups: There were 60 cases in the model group,60 cases in the brain group,and 55 cases in the brain-visceral group: liver-type group is 60 cases,brain-type group is 60 cases,brain-visceral group is 55 cases.WD heterozygote group: 30 heterozygote were collected from patients with WD as heterozygote.Normal control group: The data of 20 normal controls of AEEG and 32 normal controls of PSG were from young medical staff and relatives of this hospital,excluding any disease and physical discomfort.2.All subjects were examined with AEEG and/or PSG using a portable ambulatory electroencephalograph.3.Using SPSS 17.0 statistical software to analyze the differences between AEEG and(or)PSG in each group.Results:1.Through the research of AEEG in WD patient group,WD heterozygote group and normal control group,the abnormal rate,abnormal degree and abnormal performance of WD patients and heterozygote AEEG were explored.The results showed that:(1)The abnormal rate of AEEG in patients with WD was 56.6%,and the degree of abnormality was mainly mild to severe.The abnormal rate of AEEG in WD group was significantly higher than that in WD heterozygote group and normal control group(P<0.05),but there was no difference in AEEG abnormal rate between WD heterozygote group and normal control group(P>0.05).(2)There was significant difference in the abnormal rate of AEEG between the liver-type group,brain-type group and brain-visceral group(P<0.05).The abnormal rate of AEEG in the three groups was highest:the abnormal rate of AEEG in brain group(70.0%)was highest,the abnormal rate of AEEG in brain-visceral group(67.3%)was the second,and the abnormal rate of AEEG in liver-type group(33.3%)was the lowest.(3)The abnormal rate of AEEG in brain group was higher than that in heterozygote group(P<0.05)and normal control group(P<0.05);the abnormal rate of AEEG in brain-visceral group was higher than that in heterozygote group(P<0.05)and normal control Group(P<0.05);while the abnormal rate of AEEG in liver-type group was not different from heterozygote group and normal control group(P>0.05).(4)The wave rates of liver-type group?brain groupand brain-visceral group group were significantly slower than heterozygote(P<0.01)and normal controls(P<0.01),and the rhythm was disordered,and the amplitude of modulation was poor.Slow wave rhythm;liver-type group rate was slower than that of brain group(P<0.05),and there was no difference in wave rate between liver-type group and brain-visceral group,brain group and brain-visceral group(P>0.05).Heterozygote group wave rate and normal control group no difference(P> 0.05).Seizure waves were significantly more pronounced during sleep than when they were awake(P<0.05).2.Through the research of PSG monitoring in WD patient group,WD heterozygotegroup and normal control group,the differences in sleep efficiency and sleep structure between WD patients and their heterozygote were explored.Research indicates:(1)The total sleep time(TST)?sleep efficiency(SE)?deep sleep ratio [S3+S4(%)]and fast eye movement sleep ratio(REM)in the WD group were lower than those in the heterozygote group(P<0.05).In the control group(P<0.05),sleep latency(SL),awakening frequency(AT),and NREM ratio [S2(%)] were all higher in the WD group than in the heterozygote group(P<0.05)and the normal control group(P<0.05).This shows that WD patients have low sleep efficiency,prolonged latency,awakening and a low proportion of deep sleep.(2)The heterozygote subgroup TST?SE?REM were all lower than the normal control group(P<0.05).The heterozygote group SL?AT?S2?S3+S4(%)had no significant difference with the normal control group(P>0.05).The results showed that the sleep efficiency of the heterozygote subgroup was lower than normal,and there was no difference in sleep latency,arousal frequency,and deep sleep ratio between the two groups.(3)TST?SL?AT?S2?S3+S4(%)and REM in liver-type group were lower than those in brain group(P<0.05).TST?SE?SL?AT and REM in liver-type group were all lower than those in brain-visceral group(P<0.05),SL?AT and S2 were lower in the brain group than in the brain-visceral type(P<0.05).It indicated that the brain-visceral group had the longest sleep latency,the most awakening times,followed by the brain type,the shortest incubation period of the liver type sleep,and the least number of wakefulness.(4)TST?SE?S3+S4(%)?REM were lower in liver-type group,brain group and brain-visceral group than heterozygote group(P<0.05)and normal control group(P<0.05);The SL ? AT and S2 levels in the liver-type group,brain group and brain-visceral group were higher than those in the heterozygote(P<0.05)and normal controls(P<0.05).The results showed that the sleep efficiency,deep sleep ratio of liver-type group,brain group and brain-visceral group were lower than that of heterozygote group and normal control group.Sleep latency and awakening frequencywere higher than those of heterozygote group and normal control group.Conclusions:1.The AEEG abnormalities in WD patients are obvious with brain type and brain-visceral type,and their basic rhythm is slowed down.2.WD patients with abnormal sleep structure?brain-visceral type and brain type is obvious,and its heterozygote also have abnormal sleep structure.3.Clinical research on the monitoring of WD patients and their heterozygote AEEG and PSG filled the gaps and deficiencies in the research field. |
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