帕金森病患者睡眠障碍相关因素的分析

目的探讨帕金森病(Parkinson’s disease,PD)患者睡眠障碍的相关因素。方法对96例PD患者(PD组)和98例年龄、性别相匹配对照者(对照组)进行匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PQSI)、爱泼沃斯思睡量表的问卷调查。结果有63.54%的PD患者总体睡眠质量差,睡眠质量差者病程长、Hoehn和Yahr(H&Y)分期高、统一PD评定量表-运动检查(UPDRS-Ⅲ)指数高、左旋多巴的应用和剂量大以及抑郁发生率高;多因素logistic回归显示睡眠质量与H&Y分期、UPDRS-Ⅲ评分、左旋多巴的应用和剂量显著相关。有梦魇的PD患者H&Y分期高、UPDRS-Ⅲ评分高以及服用苯海索剂量大。PD患者有日间过度思睡者年龄大、病程长、H&Y分期高、UPDRS-Ⅲ指数高、PQSI分值高以及左旋多巴的剂量大;多因素logistic回归显示日间过度思睡与H&Y分期、UPDRS-Ⅲ评分以及PQSI分值显著相关。结论PD患者的睡眠状况与年龄、疾病的严重程度以及抗PD药物的使用和剂量相关。

Factors related to sleep disorders in Parkinson's disease

Objective To analyze the factors related to sleep disorders in patients with PD.Methods Ninety-six consecutive patients with PD and 98 sex-and age-matched ones as the controls participated in subjective sleep evaluation.Sleep assessment was performed using both PQSI and ESS questionnaire.Results The poor quality of sleep was observed in 63.54% of PD patients.The PD patients with poor quality of sleep had long duration of disease,high Hoehn and Yahr(H&Y) scores,high UPDRS-Ⅲ scores,high dosage of levodopa and high rate of depression.Multivariate logistic regression analysis showed that the quality of sleep was significantly related to H&Y scores,UPDRS-Ⅲ scores,use and dosage of levodopa.The nightmare in PD patients was associated significantly with high H&Y scores,UPDRS-Ⅲ scores and trihexyphenidyl dosage.The PD patients with excessive daytime sleepiness(EDS) appeared to have old ages,long duration of illness,high H&Y scores,high UPDRS-Ⅲ scores,high PQSI scores,and high dosage of levodopa.Multivariate logistic regression analysis showed that EDS was associated significantly with H&Y scores,UPDRS-Ⅲ scores,and PQSI scores.Conclusion Sleep disorders in patients with PD were correlated with old ages,severity of PD,and the use or dosage of antiparkinsonian medications.