广州地区帕金森病患者睡眠障碍情况调查

目的 调查广州地区帕金森病(Parkinson's disease,PD)患者睡眠质量,分析睡眠障碍特点及影响因素.方法 由中国医学科学院北京协和医院张振馨教授设计,采用PD非运动症状调查问卷中PD睡眠量表(PDSS)及Epworth嗜睡评分量表(ESS)对2007年4-6月在广州6家医院门诊或住院部的PD患者共107例进行睡眠情况调查,用统一PD评分量表(UPDRS)及Hoehn-Yahr(HY)分级进行运动功能的评定,了解睡眠与运动功能之间的关系.结果 107例PD患者中20.6%(22/107)的患者存在睡眠障碍,18.7%(20/107)的患者可能存在睡眠障碍.PD患者睡眠障碍的特点主要为夜尿增多、白天睡眠增多、睡眠浅.PD患者睡眠障碍与病程、H-Y分级、UPDRS及ESS评分相关(rs=-0.322、-0.259、-0.231、-0.198,均P＜0.05).UPDRS得分越高、H-Y分级越大以及病程越长则睡眠情况越差.左旋多巴类药物用量在有或无睡眠障碍患者中差异无统计学意义.结论 睡眠障碍在广州地区PD患者中较常见,主要表现为夜尿增多、睡眠浅及白天睡眠增多,PD的严重程度可能影响患者睡眠质量.

Characteristics of sleep disorder in patients of Parkinson' s disease in Guangzhou city

Objective To determine the frequency and nature of sleep disturbances in patients with Parkinson's disease (PD) in Guangzhou.Methods Parkinson' s Disease Sleep Scale (PDSS) and Epworth Sleep Scale (ESS) were used to evaluate the sleep disturbances of Parkinsonian patients.The severity of PD was also evaluated.All data was obtained by means of questionnaire and physical examination by neurologists.The study was carried out from April to June in 2007 in 6 hospitals in Guangzhou city.These patients were outpatients or inpatients.Unified Parkinson' s Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (H-Y) were used for evaluating the movement function and the relationship between the sleep and movement.Results A total of 107 PD patients were included.Twenty-two patients (20.6%)were identified as marked sleep disorder,while 20 patients (18.7%) were possible sleep disorder.Nocturia,daytime sleep and sleep maintenance insomnia were the three most troublesome reported symptoms causing sleep disturbance.There was significant correlation between total PDSS scores and total UPDRS scores,H-Y stage,disease duration and ESS scores (rs=-0.322,-0.259,-0.231,-0.198,all P ＜0.05).The dose of antiparkinsonian drugs had no relationship among groups with or without sleep disturbance according to PDSS.Conclusion Sleep disturbances are a relatively common complications of PD in Guangzhou and will become worse with increasing H-Y stage.