帕金森病伴发认知功能障碍患者的临床特点及其与睡眠障碍的关系  

Clinical characteristics of patients with Parkinson disease accompanied with cognitive impairment and its relationship with sleep disorders

作　　者：郭鹏[1] 左丽君[1] 连腾宏 扈杨 余舒扬[1] 金朝[1] 余秋瑾 刘丽[2] 王瑞丹[1] 李丹凝 朴英善[1] 李丽霞[2] 朱荣彦[1] 丁杜宇 高俊华[1] 赵慧[2] 张巍[3,4,5,6,7] Guo Peng;Zuo Lijun;Lian Tenghong;Hu Yang;Yu Shuyang;Jin Zhao;Yu Qiujin;Liu Li;Wang Ruidan;li Danning;Piao Yingshan;Li Lixia;Zhu Rongyan;Ding Duyu;Gao Junhua;Zhao Hui;Zhang Wei(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China;Department of General Internal Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China;Department of Cognitive Disorders,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China;China National Clinical Research Center for Neurological Diseases,Beijing 100050,China;Key Laboratory of Neurodegenerative Diseases,Capital Medical University,Ministry of Education,Beijing 100069,China;Center of Parkinson’s Disease,Beijing Institute for Brain Disorders,Beijing 100053,China;Beijing Key Laboratory on Parkinson disease,Beijing 100053,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,100050 [2]首都医科大学附属北京天坛医院综合内科,100050 [3]首都医科大学附属北京天坛医院认知障碍性疾病科,100050 [4]国家神经系统疾病临床医学研究中心,100050 [5]教育部神经变性疾病重点实验室,北京100069 [6]北京脑重大疾病研究院帕金森病研究所,100053 [7]帕金森病研究北京市重点实验室,100053

出　　处：《神经疾病与精神卫生》2019年第1期17-20,共4页Journal of Neuroscience and Mental Health

基　　金：国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(2016YFC1306000;2016YFC1306300);国家重点研发计划政府间国际科技创新合作重点专项(YS2017YFGH001141);国家自然科学基金项0(81571229);北京市自然科学基金委员会-北京市教育委员会联合资助项目(KZ201610025030);首都医科大学校自然科学基金(PYZ2018077);北京天坛医院2015年度青年科研基金(2015-YQN-14).

摘　　要：目的探讨帕金森病(PD)伴发认知功能障碍(CI)患者的临床特点及睡眠情况。方法连续纳人2014年5月一2017年5月就诊于北京天坛医院的394例PD患者,按照CI程度将患者分为PDF伴认知功能障碍(PD-NCI)组(94例,23.86%)、PD伴发轻度认知功能障碍(PD-MCI)组(177例,44.92%)及PD伴发痴呆(PDD)组(123例,31.22%)。收集患者的人口学资料,采用蒙特利尔认知评估(MoCA)量表评价患者的认知功能,比较3组患者总体认知功能及各认知领域情况;采用视频多导睡眠图(v-PSG)评估患者的睡眠状况,并对P1)伴发CI患者的MoCA量表总分及各认知领域评分与v-PSG结果进行相关性分析。结果3组患者性别、起病年龄、受教育水平及病程差异均无统计学意义(P﹥0.05)。PDNCI组、PD-MCI组和PDI)组MoCA量表总分依次明显降低,分别为(22.20±4.99)分、(17.17±4.36)分和(10.73±4.85)分(P=143.146,P﹤0.01),且MoCA量表各认知领域评分依次明显降低(P﹤0.01)。与PD-NCI组比较,PD-MCI组总睡眠时间减少,睡眠效率降低,觉醒次数增加(均P﹤0.05);与PD-MCI组比较,PDD组总睡眠时间减少,睡眠效率降低,觉醒次数增加(均P﹤0.05)。PD伴发CI的患者的睡眠效率与MoCA量表总分及视空间功能、执行功能、延迟回忆和注意力评分均呈正相关(P﹤0.05),觉醒次数与MoCA量表总分及延迟回忆和注意力评分均呈负相关(P﹤0.05)。结论PD患者CI发生率较高,伴发CI的PD患者总体认知功能及各认知领域均明显受损,总体睡眠时间减少,睡眠效率降低,觉醒次数增加,并与总体认知功能及部分认知领域受损有关。Objective To investigate the clinical characteristics of Parkinson disease(PD)patients accompanied with cognitive impairment(CI)and the sleeping status.Methods A total of 394 patients with PD in Beijing Tiantan Hospital from May 2014 to May 2017 were enrolled.According to Cl level,the patients were divided into PD without cognitive impairment(PD-NCI)group(n=94,23.86%),PD with mild cognitive impairment(PD-MCI)group(ai=177,44.92%),and PD with dementia(PDD)group(w=123,31.22%).The demographic data of the patients were collected and the cognitive function of the patients was evaluated by Montreal Cognitive Assessment Scale(MoCA).The general cognitive function and the cognitive domains of the three groups were compared.Sleep status was assessed by video polysomnography(v-PSG).The correlation between the total score of MoCA scale,cognitive domain score and the results of v-PSO in patients with PD and Cl was analyzed.Results There was no statistical significance in the differences in gender,age of onset,education level and duration of disease among the 3 groups(P﹥0.05).The total score of MoCA scale in PD-NCI group,PD-MCI group and PDD group decreased one hy one(22.20±4.99),(17.17±4.36)and(10.73±4.85)(F=143.146,P﹤0.01).The scores of MoCA scale in each cognitive field were significantly decreased in turn(P﹤0.01).Compared with PD-NCI group,PD-MCI group had less total sleep time,lower sleep efficiency and increased arousal frequency(P﹤0.05).Compared with PD-MCI group,PDD group had less total sleep time,lower sleep efficiency and increased arousal frequency(P﹤0.0.05).The sleep efficiency of PD-CI patients was positively correlated with the total score of MoCA scale,visual spatial function,executive function,delayed recall and attention score(P﹤0.05).Fhe number of arousal in PD-CI patients was negatively correlated with the total score of MoCA scale,delayed recall and attention score(P﹤0.05).Conclusions The incidence of Cl was higher in PD patients.The overall cognitive function and cognitive fields of PD pati

关 键 词：帕金森病 认知功能障碍 睡眠障碍 

分 类 号：R749.16[医药卫生—神经病学与精神病学]