摘要
目的研究多系统萎缩（MSA）患者的主客观睡眠障碍。方法选取2013年6月至2015年8月广东省人民医院神经内科住院的MSA患者30例，对照组25例，采用非运动症状量表睡眠分项、匹兹堡睡眠质量指数（PSQI）及帕金森病睡眠量表-2（PDSS-2）评价其主观睡眠障碍，同时行多导睡眠图（PSG）评价其客观睡眠障碍。结果30例MSA患者中有29例（96．7％）至少存在1项睡眠障碍主诉。MSA组的PSQI总分（分）、PDSS-2总分（分）较对照组显著增高（PSQI：9．37±4．60和5．36±2．86，t=-3．934，P〈0．01；PDSS-2：15．60±10．02和5．48±2．74，t=-5．300，P〈0．01），MSA组睡眠量表的部分因子分与增龄、运动症状相关。PSG示MSA组患者总睡眠时间减少，睡眠效率减低，各期睡眠比例未见差异；确诊快速动眼睡眠行为障碍（RBD）者24例（80．0％），其中仅2例表现为暴力动作；MSA组周期性肢体运动（PLMS）指数增高。以帕金森症候群为主的MSA（MSA—P）组PDSS-2总分较以共济失调为主的MSA（MSA—C）组增高（17．79±10．01和6．83±2．40，t=4．834，P〈0．01）。结论MSA患者存在多种睡眠障碍；其睡眠结构改变以睡眠时长减少、睡眠效率减低为主，各期睡眠比例变化不明显；RBD发生率高而症状轻；PLMS在MSA患者多见且程度较重；MSA-P患者的睡眠主观体验与运动症状相关，且较MSA—C患者更差。
Objective To investigate the subjective and objective sleep disorders in patients with multiple system atrophy （MSA）. Methods Thirty MSA patients and 25 age-and-sex matched controls were enrolled. Sleep disorders were assessed by Pittsburgh Sleep Quality Index （ PSQI）, Parkinson＇ s Disease Sleep Scale-2 （ PDSS-2 ）, and polysomnography （ PSG ） . Results Twenty-nine （ 96.7% ） patients complained of sleep disorders. The PSQI and PDSS-2 scores were significantly higher in MSA group than those in control group （PSQI： 9. 37 ±4. 60 vs 5.36 ± 2. 86, t =-3. 934,P 〈 0.01 ;PDSS-2 ： 15.60 ± 10. 02 vs 5.48 ± 2. 74, t = - 5. 300, P 〈 0. 01 ）. Some parameters of sleep scales were correlated with advancing ages and the severity of symptoms in MSA with predominant parkinsonism （MSA-P） patients. PSG revealed reduced total sleep time （T ST） and sleep efficiency （SE） and higher periodic limb movement in sleep （PLMS） index in MSA patients. Rapid eye movement sleep disorder （RBD） was confirmed by PSG in 24 （80. 0% ） patients, with only 2 of whom manifesting violent behaviors. The patients with MSA-P showed higher PDSS-2 scores than patients with MSA with predominant eerebellar ataxia （MSA-C; 17.79 ± 10.01 vs 6.83±2.40, t=4.834, P〈0.01）. Conclusions Sleep disorders are common in MSA patients. The sleep structure impairments mainly consist of reduced TST and SE with the proportion of sleep stages unchanged. RBD occurs frequently while the symptom is usually mild. PLMS is not rare, and the PLMS index is high. The subjective sleep quality in MSA-P patients was correlated with the severity of parkinsonian symptoms and poorer than that in MSA-C patients.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2016年第4期294-298,共5页
Chinese Journal of Neurology
基金
国家自然科学基金资助项目（81371401,81501112）
广东省科技计划项目（2015A050502032,20138021800199）
广东省自然科学基金资助项目（2015A030313536）
