北京协和医院成年人不安腿综合征调查  

Restless Legs Syndrome in Adults in Peking Union Medical College Hospital

作　　者：陈健华[1] 黄蓉[2] 罗金梅[2] 肖毅[2] 钟旭[2] 刘秀琴[1] CHEN Jian-hua HUANG Rong LUO Jin-mei XIAO Yi ZHONG Xu LIU Xiu-qin(Department of Neurology Department of Respiratory, PUMC Hospital, CAMS and PUMC, Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院神经科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院呼吸内科,北京100730

出　　处：《中国医学科学院学报》2016年第5期548-553,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的调查北京协和医院成年人不安腿综合征(RLS)患者的患病情况、疲劳严重度、睡眠质量、日间嗜睡、病情严重度及焦虑抑郁情况。方法连续入组有睡眠相关症状主诉的门诊患者4739例,年龄小于18岁者排除在外。所有受试者回答RLS量表,满足4个条件的患者将接受随访以及进一步检查。RLS症状严重度使用中国国际RLS量表(IRLS-C)评估。收集同时期年龄性别匹配的无睡眠障碍或肢体不适、未服用任何药物的健康者和连续门诊就诊的失眠而非RLS的患者作为正常对照组(n=42)和非RLS失眠对照组(n=42)。采用皮茨堡睡眠质量量表(PSQI)、疲劳严重度量表(FSS)、爱泼沃斯嗜睡量表(ESS)和综合医院焦虑抑郁量表(HADS)对原发性RLS患者和正常对照组及非RLS失眠对照组患者进行评估和比较。结果 4739例有睡眠相关症状主诉的门诊患者中,有162例(3.42%)满足4条标准,其中,24例因为临床资料不完整或失访归为原因不明分类不清的RLS,42例(0.89%)为原发性RLS,63例(1.33%)为继发性RLS,33例(0.70%)为RLS样疾病。42例原发性RLS患者中,41例(97.6%)睡眠质量差,13例(31.0%)存在焦虑,4例(9.5%)有抑郁。原发性RLS患者的PSQI(q=11.69,P=0.000)、HADA(q=8.02,P=0.000)和HADD(q=6.60,P=0.000)得分明显高于正常对照组,FSS(q=3.74,P=0.001)、ESS(q=2.97,P=0.012)和HADD(q=4.15,P=0.000)得分明显低于非RLS失眠对照组患者。HADA和HADD评分与PSQI评分(r=0.340,P=0.028;r=0.383,P=0.012)、FSS评分(r=0.445,P=0.003;r=0.511,P=0.001)及IRLS评分(r=0.477,P=0.001;r=0.578,P=0.000)呈显著正相关。结论对因为失眠和/或肢体不适感而就诊的患者应考虑RLS的可能。原发性RLS患者睡眠质量差,焦虑抑郁发生率高。临床医生需要对原发性和继发性RLS进行鉴别诊断,同时除外RLS样疾病。Objective To investigate the clinical characteristics of restless legs syndrome（ RLS） in adults in Peking Union Medical College Hospital and explore the sleep quality,fatigue degree,daytime sleepiness,disease severity,depression and anxiety of RLS patients.Methods Totally 4739 consecutive patients who visited the outpatient departments with any sleep complaint or leg discomforts were recruited in the study.Patients under 18 years were excluded.All participants answered RLS questionnaire.The subjects fulfilled all four criteria would be followed up and given advanced examinations to rule out secondary RLS and RLS mimics.Primary RLS patients were evaluated with International Restless Legs Scale（ IRLS）,Pittsburgh Sleep Quality Index（ PSQI）,Fatigue Severity Scale（ FSS）,Epworth Sleepiness Scale（ ESS）,and Hospital Anxiety and Depression Scale for depression and anxiety（ HADD and HADA）.Another two groups of age-and gender-matched healthy subjects andnon-RLS insomnia patients were served as normal and non-RLS insomnia controls.Results There were 162（ 3.42%,162/4739） subjects fulfilling all four criteria for RLS; 42（ 0.89%,42/4739） subjects were diagnosed as primary RLS and 33（ 0.70%,33/4739） as RLS mimics.In primary RLS patients,41（ 97.6%）were found to be with poor sleep,13（ 31.0%） with anxiety,and 4（ 9.5%） with depression.The scores of PSQI（ q = 11.69,P = 0.000）,HADA（ q = 8.02,P = 0.000）,and HADD（ q = 6.60,P = 0.000） in primary RLS patients were significantly higher than those in normal controls.The scores of FSS（ q = 3.74,P =0.001）,ESS（ q = 2.97,P = 0.012）,and HADD（ q = 4.15,P = 0.000） in primary RLS patients were significantly lower than those in non-RLS insomnia controls.The scores of HADA and HADD were significantly correlated with those of PSQI（ r = 0.340,P = 0.028; r = 0.383,P = 0.012）,FSS（ r = 0.445,P = 0.003;r = 0.511,P = 0.001）,and IRLS（ r = 0.477,P = 0.001; r = 0.578,P = 0.000）.Conclusions RLS should be considered in the patien

关 键 词：不安腿综合征 睡眠 疲劳 焦虑 抑郁 

分 类 号：R741[医药卫生—神经病学与精神病学]