帕金森病伴发快速眼动期睡眠行为障碍的相关性研究  

Correlation study between Parkinson's disease and REM sleep behavior

作　　者：刘姝[1] 苏庆杰[1] 黄如萍[1] 陈聪[1] 王德生[1] 李莉[1] 

机构地区：[1]海南省农垦总医院神经内科,海口570311

出　　处：《疑难病杂志》2015年第7期689-691,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：海南省卫生厅医学科研基金(No.琼卫2011-70)

摘　　要：目的观察快速眼动期睡眠行为障碍(RBD)在帕金森病中的发生率、出现时间、电生理特点,探讨RBD与帕金森病之间的关系。方法通过对患者的既往睡眠状况调查以及多导睡眠监测(PSG).观察患者的睡眠障碍特征。(1)主观睡眠调查:帕金森病(PD)组患者60例,年龄匹配的健康对照组60例,询问睡眠史,了解RBD出现的比例及出现时间。(2)PSG:对120例受试者接受连续2夜的PSG监测,对出现RBD的帕金森病患者分析其PSG特点。结果 PD组合并RBD占75.0%(45/60),明显高于健康对照组的40.0%(24/60),其中RBD早于临床PD主症的患者比例是40.0%(18/45)。PSG检测结果发现:PD合并RBD最主要的PSG特点是:快速眼动睡眠(REM)期(快速眼动睡眠期)肌肉失弛缓和全身骨骼肌活动增多,与健康对照组比较,差异有统计学意义(t=23.2、20.6,P<0.01)。结论 PD患者伴发RBD率高,部分RBD先于经典运动症状出现,提示RBD可能为PD的早期表现。PSG特征可以作为PD伴发RBD的诊断指标之一。Objective To observe the occurrence rate, onset time and electrophysiological characteristics of REM sleep behavior disorder （ RBD） in patients with Parkinson＇s disease, and to explore the relationship between RBD and Parkin-son＇s disease.Methods According to previous survey of sleep quality and guide polysomnography（ PSG） to observe the char-acteristics of sleep disorder.（1） Subjective sleep investigation： Parkinson＇s disease （ PD） group of 60 cases, age matched healthy control group with 60 cases, asking sleep history to understand the proportion of RBD and time.（2） PSG：120 sub-jects received PSG monitoring for 2 consecutive nights.To analyze the PSG characteristics of RBD patients with Parkinson＇s disease.Results The PD combined with RBD was 75.0%（45/60）, which were significantly higher than those in healthy control group of 40.0%（24/60）,the proportion of patients with RBD early than clinical symptom of PD was 40.0% （18/45）.The PSG test showed that the main PSG characteristics in PD with RBD： Rapid eye movement （REM） sleep period, muscle loss of achalasia and systemic activity of skeletal muscle were increased, compared with the healthy control group, the difference were statistically significant （ t =23.2, t =20.6, P 〈0.01）.Conclusion The RBD rate is high in PD patients, part of RBD precede the classical motor symptoms appearance, which suggesting that RBD maybe the early manifestations of PD.The PSG is an diagnostic index of PD associated with RBD.

关 键 词：帕金森病 快速眼动期睡眠行为障碍 多导睡眠监测 

分 类 号：R742.5[医药卫生—神经病学与精神病学]