早期帕金森病患者快速动眼睡眠行为障碍的研究  

Study of rapid eye movement sleep behavior disorder in patients with Parkinson disease at early stage

作　　者：张长国[1] 冯耀耀[1] 陈静[1] 张强春[1] 

机构地区：[1]浙江省湖州市第三人民医院神经内科,313000

出　　处：《临床神经病学杂志》2013年第5期369-371,共3页Journal of Clinical Neurology

摘　　要：目的研究早期帕金森病(PD)患者快速动眼睡眠行为障碍(RBD)的状况及特征。方法采用国际睡眠障碍分类标准中RBD最低诊断标准对68例早期PD患者进行诊断,进行统一PD评分量表Ⅲ(UPDRSⅢ)、H-Y分级评定和运动障碍分型,以及简易精神检查(MMSE)、额叶执行能力量表(FAB)和PD睡眠量表(PDSS)、Epworth嗜睡量表(ESS)评分。采用PD患者RBD相关问卷调查RBD患者的临床表现。结果本组患者中诊断为RBD 24例(35.3%),无RBD 44例。PD合并RBD组患者的PDSS评分显著低于无RBD组(P<0.05)。RBD表现为发声24例,肢体动作20例,防御或攻击行为5例;其中以出现讲话(24例)、喊叫(18例)和下肢蹬车样动作(14例)的最多,而起床行走(1例)、伤害同睡者(2例)较少。两组的一般资料及H-Y分级、左旋多巴剂量、运动障碍分型、UPDRSⅢ、MMSE、FAB、ESS评分比较,差异均无统计学意义。结论早期PD患者合并RBD的比率高,对睡眠质量影响较大;RBD的主要表现为睡眠中讲话、喊叫及下肢蹬车样运动。Objective To study the condition and features of rapid eye movement sleep behavior disorder （RBD） in patients with Parkinson disease （PD） at early stage. Methods Sixty-eight early PD patients were determined according to international classification of sleep disorder minima[ clinical criteria of RBD. Unified PD rating scale ~ （UPDRS ~ ）, Hoehn-Yahr （H-Y） stage, motor sub-type and mini mental state examination （MMSE）, frontal assessment battery （FAB）, PD sleep scale （PDSS）, epworth sleepiness scale（ESS） were used to evaluate PD patients motor symptoms and non motor symptoms. RBD characteristics were investigated by an interview administered questionnaire for RBD. Results In this group, there were 24 cases （35.3%） with RBD and 44 cases without RBD. The PDSS score in PD with RBD group was significantly lower than that in PD without RBD group （ P 〈 0.05 ）. The clinical manifestations of RBD were vocalizations during sleep in 24 cases, pantomimes in 20 cases and defence or attack in 5 cases. The events were mostly talking （24 cases） , shouting （18 cases） and lower limb pedaling movements （ 14 cases）, but getting out of the bed and walking （ 1 case） and hurting the bed companions （2 cases） were seldom. The differences of general information, H-Y stage, dosage of L-dopa, motor sub-type, UPDRS Ill scores, MMSE scores, FAB scores and ESS scores between the two groups were no statistical significance. Conclusions RBD is commonly occurred in early stage PD patients, influencing their sleep seriously. The chief manifestations of RBD are talking, shouting or lower limb pedaling movements when sleeping.

关 键 词：帕金森病 早期 快速动眼睡眠行为障碍 

分 类 号：R742.5[医药卫生—神经病学与精神病学]