帕金森病伴认知障碍患者的睡眠质量分析  

Sleep efficiency in patients with Parkinson＇s disease with cognitive impairment

作　　者：黄静[1] 张玉虎[1] 聂坤[1] 冯淑君[1] 朱睿明 甘蓉[1] 唐红梅[1] 王丽敏[1] 赵洁皓[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)神经内科 广东省神经科学研究所,广州510080

出　　处：《中华神经科杂志》2014年第7期501-504,共4页Chinese Journal of Neurology

基　　金：国家自然科学基金资助项目（81371401,30801219,30870863,81271560）;广东省自然科学基金资助项目（s2013010014033）;广东省科技计划项目（2011B080701087）;广东省医学科研基金资助项目（A2010033）

摘　　要：目的 比较帕金森病伴认知障碍患者与帕金森病认知正常患者睡眠质量的差异,并分析帕金森病患者睡眠与认知障碍之间可能存在的关系.方法 收集2012年2月至2013年10月在广东省人民医院神经科就诊的帕金森病患者共109例,进行MMSE、蒙特利尔认知评估量表（MoCA）、韦氏智力及记忆力的认知评估,根据评估结果将其分为认知障碍组46例,认知正常组63例.使用帕金森病睡眠评估量表-2（PDSS-2）、匹兹堡睡眠质量指数量表（PSQI）、Epworth嗜睡量表评估所有患者的睡眠情况.结果 认知障碍组比认知正常组的PDSS-2和PSQI总分高,差异具有统计学意义[分别为（23.88±13.00）分与（13.80 ±9.76）分,t=-3.745,P＜0.01;（10.58 ±4.89）分与（6.87±4.64）分,t=-3.269,P=0.001].认知障碍组的PDSS-2-2 ～6、9的评分较认知正常组高;PSQI各分项中,认知障碍组的睡眠质量[（1.76±1.00）分]、入睡时间[（1.42±1.09）分]、睡眠效率[（1.52±1.28）分]、睡眠障碍[（1.61±0.56）分]的评分较认知正常组[（1.04±0.85）、（0.91±1.08）、（0.89±1.17）、（1.25±0.65）分,t=-3.134,-2.286,-2.363,-2.590,均P＜0.05]高.MoCA评分与PDSS-2总分和PSQI总分呈负相关（r=-0.24,P=0.03;r=-0.23,P=0.04）.结论 帕金森病伴认知障碍患者较认知正常患者存在明显的睡眠障碍.PDSS-2与PSQI相结合,可以初步了解帕金森病患者睡眠障碍的潜在原因和程度.Objective To assess the sleep quality in the Parkinson＇s disease （PD） patients with cognitive impairment and to analyze the possible relationship between sleep disorders and cognitive impairment in PD patients.Methods One hundred and nine PD patients were assessed cognitive function using Mini-Mental State Examination （MMSE）,Montreal Cognitive Assessment （MoCA） and Wechsler Intelligence Scale and Wechsler Memory Scale,and sleep quality was evaluated using the Parkinson＇s Disease Sleep Scale-2 （PDSS-2）,Pittsburgh Sleep Quality Index （PSQI） and Epworth Sleepiness Scale.All PD patients were divided into abnormal cognitive group （n =46） and normal cognitive group （n =63）.Results PDSS-2 and PSQI scores were significantly higher in abnormal cognitive group than in normal cognitive group （23.88 ± 13.00 vs 13.80 ±9.76,t =-3.745,P 〈0.01 ; 10.58 ±4.89 vs 6.87 ±4.64,t =-3.269,P=0.001）.The scores of PDSS-2 in PDSS-2-2,3,4,5,6,9 and PSQI in sleep quality （1.76 ± 1.00）,sleep time （1.42 ± 1.09）,sleep efficiency （1.52 ± 1.28） as well as sleep disorder （1.61 ± 0.56） were also significantly higher in abnormal cognitive group than in normal cognitive group （1.04 ± 0.85,0.91±1.08,0.89 ±1.17,1.25 ±0.65,t=-3.134,-2.286,-2.363,-2.590,all P〈 0.05）.The correlations between the scores of MoCA and PDSS-2,MoCA and PSQI were significant （r =-0.24,P =0.03 ; r =-0.23,P =0.04）.Conclusions The PD patients with abnormal cognition have lower sleep quality than those with normal cognition.Combining PDSS-2 with PSQI could preliminarily understand the underlying causes and the degree of PD patients with sleep disorders.

关 键 词：帕金森病 认知障碍 睡眠障碍 睡眠 

分 类 号：R742.5[医药卫生—神经病学与精神病学]