Chinese General Practice ›› 2022, Vol. 25 ›› Issue (33): 4168-4172.DOI: 10.12114/j.issn.1007-9572.2022.0212

• Article • Previous Articles     Next Articles

Diagnostic Significance of Suggested Immobilization Test in Restless Leg Syndrome

  

  1. 1.Department of PKU-UPenn Sleep Center, Peking University International Hospital, Beijing 102206, China
    2.Department of Respiratory and Critical Care Medicine, Peking University International Hospital, Beijing 102206, China
    3.Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100034, China
  • Received:2022-03-14 Revised:2022-08-12 Published:2022-11-20 Online:2022-09-13
  • Contact: HAN Fang
  • About author:
    ZHANG Wei and CHANG Yuan are co-first authors ZHANG W, CHANG Y, FENG J J, et al. Diagnostic significance of suggested immobilization test in restless leg syndrome[J]. Chinese General Practice, 2022, 25 (33) : 4168-4172.

制动试验对不宁腿综合征的诊断意义

  

  1. 1.102206 北京市,北京大学国际医院睡眠中心
    2.102206 北京市,北京大学国际医院呼吸与危重医学科
    3.100034 北京市,北京大学人民医院呼吸与危重医学科
  • 通讯作者: 韩芳
  • 作者简介:
    张伟和常远为共同第一作者 张伟,常远,冯军军,等.制动试验对不宁腿综合征的诊断意义[J].中国全科医学,2022,25(33):4168-4172. [www.chinagp.net] 作者贡献:张伟负责临床资料和数据的收集以及论文的撰写;常远负责论文的设计;韩芳对论文整体负责。
  • 基金资助:
    北京市科技计划项目(Z161100002616012)

Abstract:

Background

Restless leg syndrome (RLS) is a type of sensorimotor disorder, and clinical workers have made some recent developments in its pathological mechanism and treatment. Epidemiological studies have verified that RLS is notably associated with neuro-psychological diseases, kidney disease, cerebro-cardiovascular diseases, nutritional and metabolic diseases, and pregnancy disorders. The diagnostic rate of RLS is low due to lack of specific clinical symptoms, clear genetic and biological markers, and polysomnography (PSG) diagnostic criteria. There are several sleep centers in foreign countries where the suggested immobilization test (SIT) has been applied in clinical treatment and research about RLS.

Objective

To evaluate the clinical significance of SIT in RLS diagnosis.

Methods

The study enrolled 220 patients who visited the PKU-UPenn Sleep Center, Peking University International Hospital with a main complaint of discomfort in bilateral lower limbs during daytime rest or before sleep, and 150 healthy volunteers from January 2016 to June 2021. Discomfort in lower limbs was measured in healthy volunteers and RLS cases at baseline. The actual limb movement index (LMI) , periodic limb movements while awake index (PLMWI) , and periodic limb movement in sleep index (PLMSI) were evaluated with PSG. PLMWI≥40 times/h during SIT and >3 increment of self-assessment score of lower limb discomfort after SIT than the last assessment or one of early assessments were considered as positive SIT.

Results

Among the 220 RLS patients, 9 patients did not finish the SIT due to severe symptoms-induced unbearable discomfort during resting sit, the other 211 patients (95.9%) together with all healthy volunteers (100.0%) who successfully finished the SIT were finally included. There were significant differences in LMI, PLMWI and PLMSI during the SIT between healthy volunteers and patients (P<0.05) . The positive rates of SIT in RLS patients and healthy volunteers were 79.6% (168/211) and 10.0% (15/150) , respectively.

Conclusion

SIT is easily operable, it can be used as an effective auxiliary diagnostic tool for RLS.

Key words: Restless legs syndrome, Periodic limb movement index, Suggested immobilization test, Polysomnography, Diagnosis

摘要:

背景

不宁腿综合征(RLS)是一种运动-感觉障碍性疾病,近年来,临床医务工作者对于RLS的发病机制、治疗等方面的研究均取得了一定进展。流行病学研究证实,RLS与神经-精神疾病、肾脏疾病、心脑血管疾病、营养代谢性疾病及妊娠等存在明显的相关性。由于RLS的诊断主要依靠相对缺乏特异性的临床症状,无明确的基因、生物学标志物及多导睡眠监测(PSG)诊断标准,因此对该病的诊断率较低。国外的几个睡眠中心使用制动试验(SIT)用于RLS的临床和研究测试。

目的

评估SIT诊断RLS的临床指导意义。

方法

选取2016年1月至2021年6月就诊于北京大学国际医院睡眠中心,以日间静息和/或睡前双下肢不适为主诉的RLS患者共220例,健康志愿者150例。健康志愿者及RLS患者治疗前均行SIT并评估SIT期间双下肢不适程度,通过PSG记录健康志愿者和RLS患者SIT期间实际肢体运动指数(LMI)、清醒时周期性肢体运动指数(PLMWI)及睡眠中周期性肢体运动指数(PLMSI),SIT阳性标准需同时满足SIT期间PLMWI≥40次/h、SIT结束后双下肢不适症状自评得分较前1次或前几次中某1次的评分超过3分。

结果

纳入的220例患者中,9例因为症状严重,静坐不动时难以忍受不适症状而未能坚持完成SIT,成功率为95.9%(211/220)。150例健康志愿者均坚持完成SIT,成功率为100.0%。SIT期间RLS患者和健康志愿者LMI、PLMWI、PLMSI比较,差异有统计学意义(P<0.05)。211例RLS患者SIT阳性168例(79.6%),150例健康志愿者SIT阳性15例(10.0%)。

结论

SIT操作简单,可以作为RLS的有效辅助诊断工具。

关键词: 不宁腿综合征, 周期性肢体运动指数, 制动试验, 多导睡眠监测, 多道睡眠描记术, 诊断