摘要
目的评价帕金森病(PD)患者睡眠障碍(SD)的发生率,分析PD睡眠障碍的特点及相关影响因素。方法根据中华医学会神经病学分会运动障碍及PD学组制订的帕金森病诊断标准,选择连续就诊和住院治疗的131例PD患者,采用PD睡眠障碍量表(PDSS)评价睡眠障碍并分为睡眠障碍(SD)组和非睡眠障碍(NSD)组,两组均行统一PD量表UPDRS-Ⅲ、Hoehn-Yahr(H-Y)分期、改良Webster评分、简易精神状态检查量表(MMSE)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、爱泼沃斯思睡量表(ESS)、不宁腿综合征严重程度评定量表(RLSRS)及日常生活能力量表(ADL)评价和分析。两组中男性患者均行前列腺彩超检查,以排除前列腺增生排尿障碍对睡眠障碍的影响。结果 131例PD患者中有96例存在睡眠障碍(PDSS-1<6)。经逐步线性回归分析发现共有改良Webster评分、ADL评分、左旋多巴具体剂量、MMSE、吡贝地尔具体剂量、RLSRS、H-Y分期、ESS、PDSS-7、HAMD、UPDRS-Ⅲ及HAMA等12项因素引入回归方程,性别、年龄、病程及受教育程度均被回归分析逐步剔除。两组中男性患者前列腺彩超检查形态差异无显著性。结论PD患者睡眠障碍的发生率为73.3%。PD睡眠障碍的影响因素依次为抑郁、运动症状评分、病情分期、整体症状评分、日常生活能力、认知水平、吡贝地尔具体剂量、左旋多巴具体剂量、焦虑、不宁腿综合征(RLS)、幻觉及日间思睡。与性别、年龄、病程和受教育程度无关。
Objective To evaluate the occurrence of sleep disorder in Parkinson＇s disease, and investigate the characteristic and influential factors related to it .Methods Based on the movement disorders and Parkinson＇s disease study group of Chinese society of neurology clinical diagnostic criteria , 131 consecutive outpatients and inpatients with idiopathic PD were evaluated by Parkinson＇s disease sleep scale （PDSS） and were divided into sleep disorder （ SD） group and non sleep disorder （ NSD） group by PDSS-1.The two groups were evaluated by the Ⅲpart ofthe unified Parkinson＇s disease rating scale （UPDRS-Ⅲ）, Hoehn-Yahr Staging, Modified Webster score,Mini-Mental State Examination（MMSE）,Hamilton Depression Rating Scale（HAMD）, hamilton anxiety ccale（HAMA）, epworth sleepiness scale （ ESS） , restless legs syndrome rating scale （ RLSRS） and activity of daily living scale （ ADL） . Male patients in both groups underwent prostate ultrasound examination to exclude the impact of benign prostatic hyperplasia voiding dysfunction of sleep disorders .Results 96 of 131 PD patients （ 73.3%） were accompanied by sleep disorders（ SD） （ PDSS-1〈6）.Stepwise linear regression analysis showed that the modified webster score , ADL score, the daily dosage of L-dopa, MMSE, the daily dosage of piribedil , RLSRS, H-Y staging, ESS, PDSS-7, HAMD, HAMA, UPDRS-Ⅲwere factors entered in the regression equation .Gender, age, course of disease, level of education were excluded by stepwise regression analysis .The prostate ultrasonography of male patients in both groups had no significant difference in morphology .Conclusion The incidence of sleep disorders in patients with Parkinson＇s disease is 73.3%.The influence factors of it as follow are：depression, motor symptoms score, disease stage, overall symptoms score, activities of daily living, cognitive level, the daily dosage of piribedil,the daily dosage of L-dopa, anxiety, restless legs syndrome, hallucinations, daytime sleepiness .It is independent of sex, age, course of disease and degree of education .
出处
《脑与神经疾病杂志》
2015年第5期353-358,共6页
Journal of Brain and Nervous Diseases
关键词
帕金森病
睡眠障碍
影响因素
Parkinson＇s disease
Sleep disorder
Influence factor
