摘要
目的探讨帕金森病伴可能快速眼动睡眠障碍患者的临床特点。方法收集2017—2019年在复旦大学附属华东医院神经内科门诊就诊的47例帕金森病患者的临床资料,使用帕金森病统一评定量表3.0版和Hoehn&Yahr(H-Y)分级评定PD患者症状严重程度,梅奥睡眠问卷评估患者是否伴可能快速眼动睡眠障碍。结果根据伴或不伴可能快速眼动睡眠障碍,47例PD患者分为2组,PD伴可能快速眼动睡眠障碍患者31例(PD-pRBD组,66%),帕金森不伴可能快速眼动睡眠障碍患者(PD-npRBD组)16例(34%)。2组性别、年龄、发病年龄、是否服用多巴胺受体激动剂、H-Y分级、UPDRSⅡ及UPDRSⅢ评分比较差异无统计学意义(P>0.05);但帕金森伴可能快速眼动睡眠障碍患者的病程相对较长(76.84±51.41 vs41.25±39.14,P<0.05),精神、行为和情绪方面的UPDRSⅠ评分有明显差异(3.65±1.80 vs 2.19±1.68,P<0.05)。2组震颤、强直、延髓功能障碍(呛咳、流涎)和步态评分占UPDRSⅢ评分比例差异无统计学意义(P>0.05),但2组运动缓慢评分占UPDRSⅢ评分的比例(39.13±7.34 vs 46.06±6.71)差异有统计学意义(P=0.003),躯体/肢体症状比例(0.68±0.22 vs 0.54±0.24,P=0.048)差异有统计学意义(P=0.048),PD-pRBD患者有更高的比值。29%的可能快速眼动睡眠障碍患者有跌倒经历,而不伴可能快速眼动睡眠障碍组发生跌倒的患者比例只有12%,2组间跌倒发生率有显著性差异(P=0.045)。结论 PD-pRBD患者病程更长,多伴精神、行为和情绪异常,运动更趋于缓慢,容易发生跌倒和出现躯体体征。
Objective To analyze and discuss the clinical characteristics of PD patients with possible RBD.MethodsClinical data of 47 patients with Parkinson’s disease who visited the outpatient Department of Neurology of East China Hospital Affiliated to Fudan University from 2017 to 2019 were collected. The name,gender,age,onset age,onset form and course of PD patients were collected. Unified Parkinson’s disease rating scale(UPDRS)3.0 and Hoehn & Yahr were used to evaluate the severity of symptom and the stage of PD patients.Mayo sleep scale(MSQ)was used to evaluate if the patients were with rapid eye movement Sleep disorders. According to the MSQ,patients with Parkinson’s disease can be divided into two groups,one group with possible rem sleep behavior disorder(PD-pRBD group,31 cases),and the other group without rem sleep behavior disorder(PD-npRBD group,16 cases).ResultsThe prevalence of PD with pRBD was 66%,and there were no statistical differences between the two groups in gender,age,age of onset,the use of dopamine agonist,H-Y grade,UPDRSⅡ and UPDRS Ⅲ scores. However,the course of disease of patients with pRBD was relatively longer(76.84±51.41 vs 41.25±39.14,P<0.05). There was significant difference in the UPDRS I scores about mental behavior and emotion of PD(3.65±1.80 vs 2.19±1.68,P<0.05). There was no significant difference between the two groups in the ability of daily activities. And there was no difference in the proportion of UPDRS Ⅲ scores between the two groups in tremors,rigidity,bulbar dysfunction(choking,salivation)and gait scores,but there was significant difference in the proportion of UPDRS Ⅲ scores between the two groups in slow motion score(39.13±7.34 vs46.06±6.71,P=0.003). The ratio between the summed axial and limb scores(0.68±0.22 vs 0.54±0.24,P=0.048)was significantly different between the two groups(P=0.048),and PD-pRBD patients had a higher ratio. There were more cases with frozen gait in pRBD group than in non-pRBD group(42% vs 37%),but the difference was not significant(P
作者
耿艳芹
刘桂冬
丁萍
李亚健
魏文石
GENG Yanqin;LIU Guidong;DING Ping;LI Yajian;WEI Wenshi(East China Hospital Affiliated to Fudan University,Shanghai 200040,China)
出处
《中国实用神经疾病杂志》
2021年第15期1312-1318,共7页
Chinese Journal of Practical Nervous Diseases
基金
上海市自然科学基金(青年)资助项目(编号:13ZR1454000)
上海卫生健康委员会-健康老龄化专项(编号:2020YJZX0109)。
关键词
帕金森病
快速眼动睡眠行为障碍
临床特点
跌倒
躯体症状
Parkinson’s Disease
Rapid eye movement sleep behavior disorder
Clinical features
Falls
Physical symptoms
