帕金森病患者睡眠障碍特征与同型半胱氨酸关联研究  

Relationship between homocysteine and sleep disorders in patients with Parkinson's disease

作　　者：王皓 赵海龙 方雨晴 毛飞 鲁珊珊[1] 田祥奇 赵张宁[1] 唐吉友[1] 李秀华[1] Wang Hao;Zhao Hailong;Fang Yuqing;Mao Fei;Lu Shanshan;Tian Xiangqi;Zhao Zhangning;Tang Jiyou;Li Xiuhua(Department of Neurology,The First Affiliated Hospital of Shandong First Medical University&)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)神经病学科,济南250014

出　　处：《中华行为医学与脑科学杂志》2022年第2期141-147,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：山东省重大科技创新工程项目(2018CXGC1502);济南市临床医学科技创新计划(202019111)。

摘　　要：目的探究帕金森病睡眠障碍特征,并分析同型半胱氨酸与帕金森病伴睡眠障碍相关性。方法回顾性选取2017年1月至2021年6月神经内科住院的帕金森病患者75人,根据多导睡眠监测、帕金森病睡眠量表、爱普沃斯嗜睡量表分为睡眠障碍组(n=39)和非睡眠障碍组(n=36)。收集以上患者住院期间基本临床资料、血液学检查结果、量表评估资料、多导睡眠监测资料,分析帕金森患者的睡眠特征及其与同型半胱氨酸的相关性。使用SPSS 26.0统计分析软件进行t检验、Mann-Whitney U检验、Pearson分析、Spearman分析和多元Logistic分析。结果睡眠障碍组睡眠效率[(56.82±19.07)%]、N2期占比[(48.67±17.70)%]、N3期占比[9.20%(19.00%)]、腿动相关微觉醒指数[0(1.20)]低于非睡眠障碍组[睡眠效率:(82.15±5.55)%、N2期占比:(57.02±2.80)%、N3期占比:20.01%(3.93%)、腿动相关微觉醒指数:1.15(1.80)],均差异有统计学意义(t/Z=-6.087,-2.905,-3.773,-3.683,均P<0.05)。睡眠障碍组AHI[0.90(14.60)]、N1期占比[19.50%(15.70%)]、周期性肢动指数[0(24.80)]高于非睡眠障碍组[AHI:0.60(0.30)、N1期占比:12.15%(3.15%)、周期性肢动指数0(0)],均差异有统计学意义(Z=2.154,5.250,3.559,均P<0.05)。睡眠障碍组同型半胱氨酸[15.80(3.90)μmol/L]、NMSS-失眠相关评分[3.00(5.00)分]、MDS-UPDRS-Ⅰ[7.00(10.00)分]、MDS-UPDRS-Ⅲ[23.00(16.00)分]高于非睡眠障碍组[同型半胱氨:14.10(4.20)μmol/L、NMSS-失眠相关评分:0(1.00)分、MDS-UPDRS-Ⅰ:3.00(2.00)分、MDS-UPDRS-Ⅲ:17.00(4.00)分],均差异有统计学意义(Z=2.557,4.487,2.952,2.180,均P<0.05),NMSS-嗅觉相关评分[2.00(4.00)分]、PDSS[99.00(40.00)分]低于非睡眠障碍组[NMSS-嗅觉相关评分:4.50(7.00)分、PDSS:122.00(28.00)分],差异有统计学意义(Z=2.450、4.126,均P<0.05)。Hcy与帕金森病患者睡眠障碍呈正相关(r=0.297,P<0.05);二元Logistic回归分析显示同型半胱氨酸水平升高可能为帕金森病患者睡眠障碍发Objective To explore the characteristics of sleep disorders in patients with Parkinson's disease(PD)and its correlation with homocysteine.Methods Totally 75 PD patients hospitalized in the department of neurology from January 2017 to June 2021 were selected and divided into sleep disorder group(n=39)and non-sleep disorder group(n=36)according to polysomnography,Parkinson's disease sleep scale(PDSS)and Epworth sleepiness scale(ESS).The basic clinical data,hematological examination results,scale evaluation data and polysomnography monitoring data of the above patients were collected during hospitalization to analyze the sleep characteristics of patients with Parkinson's disease and its correlation with homocysteine.SPSS 26.0 statistical analysis software was used for t test,Mann-Whitney U test,Pearson analysis,Spearman analysis and multivariate Logistic analysis.Results The sleep efficiency(56.82±19.07)%,N2 phase ratio(48.67±17.70)%,N3 phase ratio(9.20%(19.00%))and the leg movement micro-arousal index(0(1.20))in the sleep disorder group were lower than those in the non-sleep disorder group sleep efficiency(82.15±5.55)%,N2 phase ratio(57.02±2.80)%,N3 phase ratio(20.01%(3.93%)),the leg movement micro-arousal index(1.15(1.80)).The differences were statistically significant(t/Z=-6.087,-2.905,-3.773,-3.683,all P<0.05).The proportion of AHI(0.90(14.60)),N1 stage(19.50%(15.70%)),and periodic limb index(0(24.80))in sleep disorder group were higher than those in non-sleep disorder group AHI(0.60(0.30)),N1 stage(12.15%(3.15%)),and periodic limb index(0(0)).The difference was statistically significant(Z=2.154,5.250,3.559,all P<0.05).The homocysteine(15.80(3.90)μmol/L),NMSS-insomnia correlation score(3.00(5.00)),MDS-UPDRS-Ⅰ(7.00(10.00)),MDS-UPDRS-Ⅲ(23.00(16.00))in the sleep disorder group were higher than those in the non-sleep disorder group homocysteine(14.10(4.20)μmol/L),NMSS-insomnia correlation score(0(1.00)),MDS-UPDRS-Ⅰ(3.00(2.00)),MDS-UPDRS-Ⅲ(17.00(4.00)),and the differences were statistically significant(

关 键 词：帕金森病 睡眠障碍 影响因素 同型半胱氨酸 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R589[医药卫生—临床医学]