帕金森病患者睡眠障碍的评价及其治疗策略  

Evaluation and therapeutics of sleep disorders in patients with Parkinson disease

作　　者：安星凯[1] 彭蓉[1] 吴妍[1] 

机构地区：[1]四川大学华西医院神经内科,四川省成都市610041

出　　处：《中国临床康复》2006年第18期116-118,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:回顾帕金森病非运动并发症睡眠障碍的病因和发病机制,帕金森病睡眠障碍的临床评价和基本的治疗策略,以提高临床医生对帕金森病睡眠障碍的认识,改善帕金森病患者的生活质量。资料来源:应用计算机检索Medline和SCI数据库2000-01/2005-10期间的相关文章,检索词“Parkinson’sdisease,sleepdisorders“,限定文章语言种类为英文。同时手工检索《Neurology》杂志2000-01/2005-10期间的相关文章。资料选择:对资料进行初审,选取原创性文章中以及综述性文献参考引文中包括上述几方面内容的文章,然后排除非随机临床试验的研究,对入选文献查找全文,以是否观点具有创新性、是否为随机对照临床试验作为纳入标准,相似的研究以近3年的优先。资料提炼:共收集到53篇关于帕金森病睡眠障碍的文章,其中18篇为观点具有创新性、随机对照临床试验文献,排除35篇为非随机对照临床试验和重复研究的文献。资料综合:①帕金森病睡眠障碍目前尚无国际公认的分类标准,国外的学者倾向于将其分为失眠、异态睡眠、过度白天睡眠3种类型。②帕金森病中黑质多巴胺能神经元丢失,导致脑内递质失衡,这是引起睡眠障碍的生化基础。夜间功能障碍可发生在帕金森病早期,非运动“关”期相关性症状可能伴随这些夜间症状波动,促进睡眠障碍的发展。抗帕金森药物,帕金森病患者的自主神经功能失调,不安腿综合征,睡眠中周期性腿动以及快速动眼睡眠行为障碍等均可影响睡眠。③帕金森病睡眠障碍的临床评价包括需在实验室中进行的多功能睡眠仪和多种睡眠潜伏期检测,以及各种简易的睡眠量表,主要包括Epworth睡眠量表和帕金森病睡眠量表。④睡眠障碍的症状间可能存在重叠,其中的一种症状可能影响或是其他症状的原因,并且对单一症状的药物治疗可能恶化或甚至诱发任何一种睡OBJECTIVE： To review the etiology and pathogenesis, the clinical evaluation and major strategies of treatment of sleepiness in Parkinson disease, which is an non-motor complication of Parkinson disease, in order to improve the recognition of clinicians for sleep disorders in Parkinson disease and the quality of life in the patients with Parkinson disease. DATA SOURCES： The related articles published between January 2000 and October 2005 were searched in Medline and SC1 databases by computer with using the keywords of ＂Parkinson disease, sleep disorders＂, and the language was limited to English. Meanwhile, the relevant articles published on Neurology of the same period were also searched manually. STUDY SELECTION： Original articles and referred articles in review about sleep disorders in Parkinson Disease were chosen after the first check, the non-clinical randomized control trial were excluded, and then the full-texts were searched. Inclusive criteria： with new ideas or clinical randomized control trial, and when refer to the similar study in the recent 3 years were considered firstly. DATA EXTRACTION： Among the 53 articles concerning sleep disorders, we excluded 35 non-randomized control trials or repetitive studies, and accepted the remains, which met the criteria. DATA SYNTHESLS：① The classification of sleep disorders in Parkinson disease had not international criterion at present, but the foreign academicians were inclined to classify them into three types of insomnia, parasomnias and excessive daytime sleep. ②The basic biochemical abnormity of sleep disorders in Parkinson disease is the disturbance of transmitters in brain due to the loss of dopaminergic neuron in substantia nigra. Nocturnal disturbances may happened during early-stage Parkinson disease, and non-motor ＂off＂-period-related symptoms might accompany the fluctuation of them, and can contribute to the development of sleepiness. On the other hand, sleep is also impacted by antiparkinson drugs, autonomic dysfunction

关 键 词：神经系统疾病 帕金森病 睡眠障碍 多巴胺药 神经递质 

分 类 号：R742.5[医药卫生—神经病学与精神病学]