帕金森病伴发快速眼动期睡眠行为障碍患者的临床特点

目的探讨伴发快速眼动期睡眠行为障碍（RBD）帕金森病患者的不同临床特点。方法对47例伴发RBD的帕金森病患者（RBD组）和47例年龄、性别相匹配不伴发RBD的帕金森病对照者（NRBD组）进行对比研究。对两组爱泼沃斯嗜睡量表（ESS）评分、简易智能量表（MMSE）评分、Hoehn—Yahr分期、帕金森综合评分量表（UPDRS）评分、左旋多巴治疗持续时间与剂量、运动并发症等临床特点进行对比分析。结果两组患者的帕金森病发病病程时长、ESS评分、MMSE评分、Hoehn—Yahr分期、UPDRS评分[Я（精神、行为和情绪），Ⅱ（t3常生活活动），Ⅲ（运动检查）]之间比较无统计学差异（P〉0．05）。帕金森病RBD组患者较早使用左旋多巴治疗，左旋多巴治疗持续时间较NRBD组长（t=4．24，P=0．04），使用左旋多巴治疗剂量大（t=8．07，P=0．01），治疗的并发症（UPDRS评分Ⅳ）与NRBD组相比较显著增加（t=7．20，P=0．01）。结论伴发RBD的帕金森病患者治疗需较早使用左旋多巴制剂且治疗剂量大，进而引发运动并发症（异动症和症状波动）明显增加。

Clinical features of Parkinson disease in rapid eye movement sleep behavior disorder

Objective To evaluate the different clinical features of the patients with Parkinson＇s disease（PD） having and not having rapid eye movement sleep behavior disorder（RBD）. Methods Forty seven PD patients fulfilled clinical diagnostic criteria of probable RBD （ RBD group） according to the published criteria. Gender and age at PD-onset matched additional 47 patients without RBD （ NRBD group） were selected. All patients were examined for Epworth sleepiness scale （ESS）, Mini-mental state examination （MMSE） ,Hoehn-Yahr stage and unified Parkinson＇s disease rating scale（UPDRS）. Furthermore the mean dose and duration of levodopa （LD） therapy, the presence of motor complications were determined in each group. Results There were no stastical significance in the mean values of PD duration,ESS, MMSE, Hoehn- Yahr stage and UPDRS（ Ⅰ , Ⅱ, Ⅲ ） scores between the two groups（ P 〉 0.05 ）. The duration of LD therapy was significantly longer in RBD group in comparison to NRBD group （ t = 4. 24, P = 0. 04） and also mean actual dose of LD was higher（ t = 8.07, P = 0. 01 ）. In RBD group, LD-related motor complications （ UPDRS Ⅳ ） were significantly common （ t = 7.20, P = 0. 01 ）. Conclusion In the current study, the patients with RBD require higher doses of LD treatment at an earlier stage of PD which eventually lead to motor complications（dyskinesias and motor fluctuation）.