摘要
目的探讨帕金森病(Parkinson disease,PD)患者合并睡眠障碍的特点,并分析睡眠障碍与精神症状的相关性。方法纳入原发性PD患者359例,按照匹兹堡睡眠量表(Pittsburgh sleep quality index,PSQI)评分分为PD伴睡眠障碍组(PD-SD组,PSQI≥7分)和PD不伴睡眠障碍组(PD-NSD组,PSQI<7分)。采用PD统一评分量表(unified Parkinson disease rating scale,UPDRS)第三部分、Hoehn-Yahr(H-Y)分级评定患者运动症状及病情严重程度,采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、24项汉密尔顿抑郁量表(24-item Hamilton depression scale,HAMD-24)、修订的情感淡漠评定量表(modified apathy evaluation scale,MAES)、PD冲动控制障碍行为评分量表(questionnaire for impulsive-compulsive disorders in Parkinson's disease-rating scale,QUIP-RS)评估精神症状,采用PSQI、日间过度嗜睡评定量表(Epworth sleepiness scale,ESS)对患者的睡眠障碍进行评估。结果359例PD患者中,睡眠障碍发生率为58.22%(209例)。PD-SD组较PD-NSD组病程长,H-Y分级中重度者多,HAMA评分、HAMD-24评分、MAES评分更高,差异均有统计学意义(P<0.01)。PD患者PSQI评分与HAMA(r=0.445,P<0.01)、HAMD-24(r=0.559,P<0.001)和MAES评分(r=0.504,P<0.001)呈正相关。ESS评分与HAMD-24(r=0.471,P<0.001)、MAES评分(r=0.522,P<0.001)呈正相关。结论睡眠障碍在PD患者中发生率高,焦虑、抑郁、情感淡漠症状与不同类型睡眠障碍的发生有关。
Objective To investigate the characteristics of sleep disorders in patients with Parkinson disease(PD),and analyze the correlation between sleep disorders and mental symptoms.Methods Three hundred fifty-nine patients with primary PD were recruited and then divided into PD with sleep disorder group(PD-SD group,PSQI≥7 points)and PD without sleep disorder group(PD-NSD group,PSQI<7 points)according to the Pittsburgh sleep quality index(PSQI)score.The third part of the Unified Parkinson disease Rating Scale(UPDRS-Ⅲ)and Hoehn-Yahr(H-Y)grading were used to assess the motor symptoms and severity of symptoms.The Hamilton Anxiety Scale(HAMA),the 24-item Hamilton Depression Scale(HAMD-24),the Modified Apathy Evaluation Scale(MAES)and the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale(QUIP-RS)were used to assess psychiatric symptoms.PSQI and the Epworth Sleepiness Scale(ESS)were used to assess patients'sleep disorders.Results Among these 359 PD patients,the incidence of sleep disturbance was 58.22%(209 cases).Compared with the PD-NSD group,the PD-SD group had a longer course of disease,higher rate of moderate to severe in H-Y grade,higher HAMA score,HAMD-24 score,MAES score,and QUIP-RS score(all P<0.01).The PSQI score of PD patients was positively correlated with HAMA(r=0.445,P<0.001),HAMD-24(r=0.559,P<0.001),and MAES score(r=0.504,P<0.001).The ESS score was positively correlated with HAMD-24(r=0.471,P<0.001)and MAES score(r=0.522,P<0.001).Conclusion Sleep disorders have a high incidence in PD patients.The symptoms of anxiety,depression,and apathy are related to the occurrence of different types of sleep disorders.
作者
王治东
孙文华
马建军
石小雪
栗铭检
黄珅
胡世玉
郑晋华
WANG Zhidong;SUN Wenhua;MA Jianjun;SHI Xiaoxue;LI Mingjian;HUANG Shen;HU Shiyu;ZHENG Jinghua(Zhengzhou University People's Hospital,Department of Neurology,Henan Provincial People's Hospital,Henan University People's Hospital,Zhengzhou 450003,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2021年第2期78-82,共5页
Chinese Journal of Nervous and Mental Diseases
基金
河南省医学科技攻关计划项目(编号:201701018)
河南省科技发展计划项目(编号:192102310085)。
