目的：探讨应激性失眠易患个体交感神经系统（ SNS）与肾上腺皮质系统（ HPA）的觉醒水平状况，以及生理觉醒水平变化指标是否是个体易患失眠症的病前预警标识。方法：345名睡眠良好的健康志愿者根据福特应激失眠反应量表（ FIRST）评分分为高分组（>17分）172人和低分组（≤17分）173人；采用动态心电图分析仪收集并分析心率变异度（ HRV）的低频（ LF）、高频（ HF）、以及LF/HF比值等频域指标；同时检测血浆皮质醇浓度（ COR）；对两组上述指标进行比较。结果：与低分组比较，高分组年龄偏小（ t=-3.59，P=0.000）、女性比率较高（χ2=11.62，P=0.000）。将两组对象匹配后（高分组74人，低分组76人）比较，高分组HRV的HF、LF偏低（ t=13.26，t=68.86），LF/HF及血浆COR浓度偏高（t=-13.46，t=-2.21），差异有统计学意义（P<0.001或P<0.05）。线性回归方程分析显示，性别、LF/HF、COR浓度与FIRST评分呈正相关（ t=3.523，t=4.826，t=2.534；P<0.01或P<0.05）。结论：应激性失眠易患者HPA和SNS的觉醒水平升高，LF/HF和血浆COR浓度可能是失眠易患性的预警指标。%Objective:To investigate the characteristics of sympathetic-nervous system( SNS)and hypo-thalamus-pituitary-adrenal system( HPA)in people with the stress-related sleep disturbance vulnerability,and to explore the predictors of the stress-related sleep disturbance for individuals susceptible to insomnia. Method:A total of 345 healthy volunteers were divided into high score group( >17 score)and low score group (≤17 score)by the Ford stress insomnia symptoms scale( FIRST). The dynamic electrocardiograph was used to analyze low frequency( LF),high frequency( HF)and LF/HF of heart rate variability( HRV). Blood at 8:00 am was taken to test the plasma cortisol( COR)level. Resuits:Compared with low score group,high score group was younger(t= -3. 59,P=0. 000)and had higher percentage of females(χ2 =11. 62,P=0. 000). Plasma COR level and LF/HF index were significantly higher(t= -13. 46,t= -2. 21),while the LF and HF index were significantly lower(t =13. 26,t =68. 86)in high score group than those in low score group (P<0. 001 or P<0. 05). Results of linear regression analysis showed that gender,LF/HF index and plasma COR level were significantly correlated with FIRST score( t =3. 523,t =4. 826,t =2. 534;P <0. 01 or P<0. 05). Conciusion:HPA and SNS arousal level are higher in individuals with stress-related sleep disturb-ance vulnerability. LF/HF and COR level may be early warning index of predisposition to sleep disturbance.
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