伴有睡眠障碍帕金森病患者的睡眠特征及其影响因素

doi:10.6040/j.issn.1671-7554.0.2017.1020

摘要/Abstract

摘要： 目的探讨伴有睡眠障碍帕金森病(PD)患者的睡眠特征及其影响因素。方法根据《国际睡眠疾病分类第3版》诊断标准、帕金森病睡眠量表(PDSS)、失眠严重程度指数量表(ISI)、Epworth嗜睡量表(ESS)得分及多导睡眠监测图(PSG)结果,选取PD伴睡眠障碍患者(PD-SD组)50例、不伴睡眠障碍患者(PD-NSD组)50例。对两组行Hoehn-Yahr(H-Y)分级评分,同时检测血清超敏C反应蛋白(hs-CRP)、血清铁(SI)、铁蛋白(SF)、转铁蛋白(TRF)的水平,分析两组之间各指标的差异和相关性。结果 PD-SD组PDSS得分、总睡眠时间、睡眠效率(SE)、REM期比例、N2期比例、N3期比例和SI的水平均低于PD-NSD组(P<0.05),ESS、ISI得分、病程、总觉醒时间,睡眠潜伏期(SL)、N1期比例、睡眠呼吸暂停低通气指数(AHI)、周期性肢体运动指数(PLMI)、hs-CRP和TRF的水平均高于PD-NSD组(P<0.05)。逐步多元线性回归方程结果示,SI的水平影响PDSS和ESS量表得分;hs-CRP水平影响ISI量表得分。结论伴有睡眠障碍PD患者睡眠特征表现为睡眠结构紊乱、睡眠质量下降、失眠严重和白天嗜睡,且伴有睡眠呼吸障碍及睡眠行为异常和异态睡眠。伴有睡眠障碍PD患者其睡眠障碍的发生可能与炎症反应和铁代谢异常有关。

关键词: 帕金森病, 睡眠障碍, 多导睡眠监测图, 炎症反应, 铁代谢

Abstract: Objective To investigate the characteristics and influencing factors of sleep disorders(SD)in patients with Parkinsons disease(PD). Methods A total of 50 PD patients with SD(PD-SD group)and 50 PD patients without SD(PD-NSD group)were included, according to the diagnostic criteria of The Third Edition of the International Classification of Sleep Disorders, Parkinson Disease Sleep Scale(PDSS), Insomnia Severity Index(ISI), Epworth Sleepiness Scale(ESS)and polysomnography(PSG). The Hoehn-Yahr(H-Y)score was graded. The levels of serum high-sensitivity C-reactive protein(hs-CRP), serum iron(SI), serum ferritin(SF)and transferring(TRF)were detected and analyzed between the two groups. Results Comparied with PD-NSD group, the PDSS score, total sleep time, sleep efficiency(SE), proportion of rapid eye movement(REM)stage, non-rapid eye movement(NREM)stage 2, NREM stage 3, and SI were shorter or lower in the PD-SD group(P<0.05); the ESS score, ISI score, course of disease, total arousal time, sleep latency(SL), proportion of NREM stage 1, apnea-hypopnea index(AHI), periodic 山东大学学报 (医学版)56卷4期 -郭配,等.伴有睡眠障碍帕金森病患者的睡眠特征及其影响因素 \=-limb movement index(PLMI), hs-CRP and TRF were longer or higher in the PD-SD group(P<0.05). Multiple stepwise analysis showed that the IS level influenced the PDSS and ESS scores, and the hs-CRP level influenced the ISI score. Conclusion Sleep disturbances in PD-SD patients are characterized by disordered sleep structure, decreased sleep quality, severe insomnia, daytime sleepiness, respiratory disorder during sleep, abnormal sleep behaviors and parasomnias. The sleep disorders of PD-SD patients may involve inflammatory reaction and iron metabolism disturbance.

Key words: Parkinsons disease, Sleep disorders, Polysomnography, Inflammatory reaction, Iron metabolism

中图分类号:

R742.5

郭配,李秀华,张晓韬,何天齐,朱梅佳,唐吉友,赵张宁,毛飞. 伴有睡眠障碍帕金森病患者的睡眠特征及其影响因素[J]. 山东大学学报 (医学版), 2018, 56(4): 76-80.

GUO Pei, LI Xiuhua, ZHANG Xiaotao, HE Tianqi, ZHU Meijia, TANG Jiyou, ZHAO Zhangning, MAO Fei. Clinical characteristics and influencing factors of sleep disorders in patients with Parkinsons disease[J]. Journal of Shandong University (Health Sciences), 2018, 56(4): 76-80.

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