帕金森病患者睡眠障碍特点分析  

Characteristics of sleep structure in patients with Parkinson's disease

作　　者：刘建安[1] 徐江涛[1] 宋永斌[1] 张晓馨[1] 杨俊[1] 于春芳[1] 吕芸[1] 

机构地区：[1]兰州军区乌鲁木齐总医院神经内科,新疆乌鲁木齐832000

出　　处：《解放军医学院学报》2014年第10期1000-1003,共4页Academic Journal of Chinese PLA Medical School

基　　金：兰州军区医药卫生科研项目(LXH-2009024)

摘　　要：目的使用多导睡眠图(polysomnogram,PSG)分析帕金森病(Parkinson's disease,PD)患者睡眠结构特点,探索影响PD患者睡眠结构的机制。方法对2011年10月-2014年2月在我院神经内科门诊或住院的33例PD患者和33例对照者行一整夜多导睡眠图监测,并对记录数据进行分析。结果 PD组早醒(4例vs 0例)、睡眠破碎(25例vs 16例)、快动眼睡眠期颏肌失张力消失(16例vs 3例)的检出率均高于对照组(P<0.05);PD组和对照组比较,PD组觉醒时间占总睡眠时间百分比、一期睡眠占总睡眠时间百分比[S1(%)]高于对照组,而三期睡眠占总睡眠时间百分比[S3(%)]及快速眼球运动(repid eyes movement,REM)期占总睡眠时间百分比[REM(%)]低于对照组;PD病程≤2年组和对照组比较,两者睡眠结构参数均无统计学差异;PD病程>2年组和对照组比较,前者觉醒时间占总睡眠时间百分比、S1(%)高于后者,S3(%)和REM(%)低于对照组;PD病程≤2年组和>2年组比较,前者在觉醒时间占总睡眠时间百分比低于后者,而REM(%)高于后者。结论帕金森病患者睡眠障碍主要表现为早醒、睡眠破碎和快动眼睡眠期颏肌失张力消失;帕金森病患者明显存在睡眠结构紊乱,浅睡期时间延长,深睡期时间缩短;病程是影响PD患者睡眠结构的一个重要因素。Objective To analyze characteristics of sleep structure in patients with Parkinson＇s disease （PD） by polysomnogram （PSG） and investigate the probable pathogenesis. Methods Clinical data about 33 patients with PD from outpatient service or inpatient department of our hospital from October 2011 to February 2014 and 33 controls who were monitored by polysomnographic （PSG） evaluation were collected and analyzed. Results Of the 33 patients, 4 were found to have early awakening vs 0 in control group, fragmented sleep in 25 vs 16 in control group, and REM sleep without atonia in 16 vs 3 in control group. The morbidity in PD patients group were significantly higher than that in controls （P 〈 0.05）. Compared with control group, the percentage of awakening time occupying total sleep time [S1 （%）] in PD patients group were higher than that in controls, S3 （%） and REM （%） in PD patients group were lower than that in controls. There were no statistical difference in sleep structural parameter between PD group （course ≤ 2 years） and controls, the percentage of awakening time occupying total sleep time and S1 （%） in PD group （course 〉 2 years） were higher while S3 （%）, REM （%） was lower than that in controls. The percentage of awakening time occupy total sleep time was higher in PD group （course ≤ 2 years） while REM （%） was lower than that of PD group （course 〉 2 years）. Conclusion The main clinical manifestations of PD patients with sleep disorder are early awakening, fragmented sleep and REM sleep without atonia. It is obviously that sleep disorder exists in PD patients, the time of light sleep becomes longer while deep sleep becomes shorter, and PD＇s course is a main factor that affects their sleep structure.

关 键 词：帕金森病 睡眠结构 多导睡眠图 

分 类 号：R742.5[医药卫生—神经病学与精神病学]