摘要
目的探索伴快速眼动期睡眠行为障碍(RBD)的帕金森病(PD)患者非运动症状(NMS)临床特点,以及RBD与NMS的相关性研究。方法收集2015-03—2016-12福建医科大学附属协和医院及福建中医药大学附属人民医院神经内科收治的PD患者69例。所有患者完成非运动症状量表(NMSS)、汉密尔顿抑郁量表-24、蒙特利尔认知评估量表(北京版)以及快速眼动期睡眠行为障碍筛查问卷(RBDSQ),使用PD生活质量问卷(PDQ-39)调查患者的生活质量(QOL)。根据RBDSQ评分将患者分为伴很可能RBD(p-RBD)组(RBDSQ≥5分)和未伴RBD(n-RBD)组(RBDSQ<5分),比较两组患者NMS特点差异,分析NMS严重程度与RBD严重程度的相关性。采用Logistic回归分析PD发生RBD的危险因素。结果研究纳入69例PD患者,其中p-RBD者12例,n-RBD者57例。p-RBD组病程长于n-RBD组(P<0.05),p-RBD组PDQ-39指数高于n-RBD组,尤其在行动能力和认知亚项上(P<0.05)。与n-RBD组比较,伴p-RBD组PD患者的NMS频数(14.2±6.5比8.5±4.6,P=0.013)和NMSS总分(58.8±35.7比30.8±20.7,P=0.021)更高,总体QOL更差(P=0.001)。NMS频数(OR=1.204,P=0.026)和病程(OR=1.209,P=0.050)是预测PD患者发生RBD的危险因素。NMSS总分、运动并发症、病程是影响PD患者QOL的预测因素(P<0.05)。结论伴p-RBD的PD患者NMS频数更高、严重程度更重。NMS的频数越高,预示出现RBD可能性越大;NMSS总体严重程度越重,预示PD患者的QOL越差。
Objective To explore the clinical features of non-motor symptoms(NMS)in Parkinson s disease(PD)patients accompanied by REM sleep behavior disorder(RBD)and the correlation between RBD and NMS.Methods We consistently recruited 69 PD patients from the inpatient and outpatient departments of neurology in the Affiliated People s Hospital of Fujian University of Traditional Chinese Medicine and Fujian Medical University Union Hospital between Mar 2015 and Dec 2016.All the participants completed the assessments of non-motor symptoms scale(NMSS),Hamilton Rating Scale for Depression(HAMD-24),Montreal Cognitive Assessment(MoCA)and REM sleep behavior disorder screening questionnaire(RBDSQ).PD Quality of Life Questionnaire(PDQ-39)was used to evaluate the quality of life(QOL)of PD patients.PD patients were divided into PD with probable RBD(p-RBD)and with negative RBD(n-RBD)groups according to RBDSQ(cutoff value≥5 score).The comparisons of the frequency and severity of NMS between these two groups patients,and also the condition of QOL,were carried out.Logistic regression analysis was used to find out the predictors of RBD in PD.Results Of the 69 PD patients included in the study,12 were p-RBD patients,57 were n-RBD patients.The course of disease of the p-RBD group was longer than that of the n-RBD group(P<0.05),and the PDQ-39 index of the p-RBD group was higher than that of the n-RBD group,especially in the action ability and cognitive subterms(P<0.05).PD patients with p-RBD had higher frequency(14.2±6.5 vs.8.5±4.6,P=0.013)and more severity(58.8±35.7 vs.30.8±20.7,P=0.021)of NMSS compared with the n-RBD group.PD patients with p-RBD experienced worse PDQ-39 SI(P=0.001).The frequency of NMS(OR=1.204,P=0.026)and disease duration(OR=1.209,P=0.050)predicted the presence of p-RBD in PD patients.Total score of NMSS,motor complications,and disease duration had negative impact on QOL of PD patients(P<0.05).Conclusions PD patients with RBD had higher frequency and worse severity of NMS.Frequency of NMS predicted the presence of RBD,and severity of NMSS predicted the state of QOL.
作者
高千仞
叶钦勇
陈晓春
GAO Qianren;YE Qinyong;CHEN Xiaochun(Department of Neurology,Fujian Institute of Geriatrics,Fujian Medical University Union Hospital;Key Laboratory of Brain Aging and Neurodegenerative Diseases,Fujian Key Laboratory of Molecular Neurology,Fujian Medical University,Fujian 350001,China)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2018年第5期327-331,共5页
Chinese Journal of Neuroimmunology and Neurology
基金
国自然科学基金面上项目(81671265)
关键词
帕金森病
REM睡眠行为障碍
非运动症状
生活质量
认知障碍
Parkinson s disease
REM sleep behavior disorder
non-motor symptoms
quality of life
cognition disorders
