昼夜节律和慢性意识障碍

M. Kanarskii, J. Nekrasova, Irina V. Vorob’eva, I. Borisov
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引用次数: 0

摘要

在植物状态和最低意识状态患者可能的治疗作用点和预后预测中,分析昼夜节律,如睡眠-觉醒周期、褪黑激素分泌、体温趋势、心率和血压,越来越受到人们的关注。在这篇综述中,我们分析了慢性意识障碍患者的昼夜节律研究,评估了标准方法可能存在的局限性,提出了开发睡眠-觉醒周期评估的概念,并评估了可能涉及重症监护病房昼夜节律紊乱的外源性因素的作用。基于研究结果,我们得出结论,为了充分发挥康复潜力,有必要开发基于多成分方法的昼夜节律评估方法,包括使用活动记录仪进行24小时监测以更准确地识别休息-活动周期,对口筋膜区域进行视频监测以提高眼视评估的可靠性并揭示隐藏模式,分析温度曲线,褪黑激素、TSH、皮质醇以及外源性因素的水平。有必要将获得的信息用于治疗、预后、诊断和康复目的
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CIRCADIAN RHYTHM AND CHRONIC DISORDERS OF CONSCIOUSNESS
Among the possible points of therapeutic action and predicting the outcome in patients in a vegetative state and minimally conscious state, the analysis of circadian rhythms, such as the sleep-wake cycle, melatonin secretion, temperature trends, heart rate, and blood pressure, attracts more and more attention. In this review, we analyzed studies on circadian rhythms in patients with chronic disorders of consciousness, assessed the possible limitations of standard methods, proposed a concept for the development of an assessment of the sleep-wake cycle, and assessed the role of exogenous factors that are likely to be involved in the disturbance of circadian rhythms in intensive care units. Based on the results of the study, we came to the conclusion that for the full realization of the rehabilitation potential, it is necessary to develop methods for assessing circadian rhythms based on a multicomponent approach, including 24-hour monitoring using actigraphy for more accurate identification of the rest -activity cycle, video monitoring of the orofascial area to increase the reliability of oculographic assessment and revealing hidden patterns, analysis of the temperature curve, the level of melatonin, TSH, cortisol, as well as exogenous factors. It is necessary to use the information obtained for therapeutic, prognostic, diagnostic and rehabilitation purposes
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