摘要
目的探讨帕金森病(PD)患者睡眠障碍的临床特征、睡眠质量评价,并分析其相关影响因素。方法采用匹兹堡睡眠质量指数量表(PSQI)、爱泼沃斯嗜睡量表(ESS)、简明精神状态量表(MMSE)、UPDRS-Ⅲ分量表、Hoehn-Yahr(H-Y)分级、综合医院焦虑/抑郁情绪测定表(HAD)及自制的睡眠情况及用药调查表分别对170例PD患者的睡眠状况、疾病严重程度、认知状况、抑郁程度、病程、多巴胺能药物应用等情况进行评定和计算。结果在170例PD患者中有141例睡眠质量差,发生率为82.9%。其中入睡困难102例(60.0%),睡眠破碎96例(56.5%),白天过度嗜睡59例(34.7%),睡眠运动障碍81例(47.7%)。多因素逐步线性回归分析显示PSQI总分与UPDRS-Ⅲ评分、H-Y分级、HAD评分、MMSE评分、左旋多巴日平均剂量及年龄相关,而与性别和病程长短无关;ESS仅与UPDRS-Ⅲ评分、左旋多巴日平均剂量相关。结论PD患者总体睡眠质量差,睡眠障碍的发生率高,主要表现为入睡困难、睡眠破碎、睡眠运动障碍、白天过度嗜睡等。PD患者睡眠障碍状况受病情严重程度、认知状态、抑郁、年龄、多巴胺能药物应用等因素影响,而与性别、PD病程长短无关。
Objective To analyze the clinical characteristics of sleep disorders and the quality of sleep in patients with Parkinson＇s disease （PD） , and to investigate the influential factors for sleep disorders. Methods Sleep status of 170 patients with PD was evaluated by Pittsburgh sleep quality index （PSQI） and Epworth sleepiness scale （ESS）. Meanwhile, the cognition, the disease severity, the level of depression, the disease course, and the daily dosage of dopamine were investigated by mini-mental state examination （MMSE） , unified PD rating scale （UPDRS）- Ⅲ, Hoehn-Yahr stages （H-Y） , hospital anxiety and depression scale （HAD） and self- made sleep information questionnaire. Results Of the 170 patients with PD, the poor quality of sleep was observed in 141 patients, with the incidence of sleep disorders of 82.9%. The manifestations of sleep disorders included： difficulties in the initiation of sleep （60.0%） , fragmented sleep （56.5%） , excessive daytime sleepiness （34.7%） , and sleep behavior disorders （47.7%）. Multivariate linear regression analysis showed that the PSQI was related to UPDRS- Ⅲ scores, H-Y grading scores, HAD scores, MMSE scores, the daily dosage of levodopa and age, but not related to gender and duration of illness. ESS was related to UPDRS-Ⅲ scores and daily dosage of levodopa. Conclusions The incidence of sleep disorders was high in patients with PD, manifesting as difficulties in the initiation of sleep, sleep fragment, sleep behavior disorders and excessive daytime sleepiness. The level of sleep disorders was associated with the disease severity, cognition state, depression, age and the daily dosage of dopamine.
出处
《国际神经病学神经外科学杂志》
2009年第3期201-205,共5页
Journal of International Neurology and Neurosurgery
关键词
帕金森病
睡眠障碍
抑郁
Parkinson＇ s disease
sleep disorder
depression
