帕金森病睡眠障碍的影响因素及其与生活质量、非运动症状、心理状态的相关性探讨  

Exploration of the influencing factors of sleep disorders in Parkinson's disease and their correlation with quality of life,non motor symptoms,and psychological status

作　　者：陈雅宁 赵洋 冯元媛 陈怡[1] 张丽[1] CHEN Ya-ning;ZHAO Yang;FENG Yuan-yuan(Department of Geriatrics,Nanjing Brain Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210029,China)

机构地区：[1]南京医科大学附属脑科医院老年医学科,江苏南京210029

出　　处：《临床和实验医学杂志》2025年第4期372-375,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金面上项目(编号:82171249);江苏省干部保健项目(编号:BJ20005)。

摘　　要：目的分析帕金森病睡眠障碍的影响因素及其与生活质量、非运动症状、心理状态的相关性。方法回顾性选取2021年1月至2023年12月南京医科大学附属脑科医院收治的189例帕金森病患者为研究对象,依据匹茨堡睡眠质量指数(PSQI)量表分为睡眠障碍组(78例,PSQI>7分)和无睡眠障碍组(111例,PSQI≤7分)。比较两组临床资料,采用多因素Logistic回归分析影响帕金森病睡眠障碍发生的因素,统计两组生活质量[39项帕金森病生活质量调查表(PDQ-39)]、非运动症状[帕金森病非运动症状问卷(PDNMS)]、心理状态相关量表[汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)]评分,采用Pearson系数分析影响因素与生活质量、非运动症状、心理状态相关性。结果睡眠障碍组总睡眠时间短于无睡眠障碍组,睡眠潜伏期长于无睡眠障碍组,慢性疼痛占比和左旋多巴等效剂量高于无睡眠障碍组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,总睡眠时间(OR=0.738,95%CI:0.599~0.908)是帕金森病睡眠障碍保护因素,慢性疼痛(OR=3.165,95%CI:1.198~2.783)、左旋多巴等效剂量(OR=3.165,95%CI:1.436~6.972)是帕金森病睡眠障碍危险因素(P<0.05)。睡眠障碍组的PDQ-39、PDNMS、HAMA、HAMD评分均高于无睡眠障碍组,差异均有统计学意义(P<0.05)。相关性分析可知,总睡眠时间与PDQ-39、PDNMS、HAMA、HAMD评分均呈负相关(r=-0.922、-0.974、-0.958、-0.958,P<0.05),慢性疼痛、左旋多巴等效剂量与PDQ-39、PDNMS、HAMA、HAMD评分均呈正相关(r=0.675、0.776、0.741、0.684,0.907、0.981、0.955、0.943,P<0.05)。结论总睡眠时间、慢性疼痛、左旋多巴等效剂量是帕金森病睡眠障碍的影响因素,且总睡眠时间与PDQ-39、PDNMS、HAMA、HAMD评分均呈负相关,慢性疼痛、左旋多巴等效剂量与PDQ-39、PDNMS、HAMA、HAMD评分均呈正相关。Objective To analyse the factors affecting sleep disorders in Parkinson's disease and their correlation with quality of life,non-motor symptoms,and psychological state.Methods One hundred and eighty-nine patients with Parkinson's disease admitted to Nanjing Brain Hospital Affiliated to Nanjing Medical University from January 2021 to December 2023 were retrospectively selected for the study and divided into the sleep-disordered group(78 cases,PSQI>7 points)and the non-sleep disordered group(111 cases,PSQI≤7 points)based on the Pittsburgh sleep quality index(PSQI)scale.Comparing the clinical data of the two groups,the influence factors were analysed by multifactorial Logistic regression,and the scores of the scale related to the quality of life[39-item Parkinson's disease quality of life questionnaire(PDQ-39)],non-motor symptoms[Parkinson's disease non-motor symptoms questionnaire(PDNMS)],and psychological state[Hamilton anxiety scale(HAMA),and Hamilton depression scale(HAMD]were counted in the two groups,so as to analyse the correlation between the influence factors and the quality of life,non-motor symptoms,and psychological state by Pearson coefficient analysis.Results Total sleep duration was shorter in the sleep-disordered group than that in the non-sleep disordered group,the sleep latency was longer than that of the non-sleep disordered group,and the percentage of chronic pain and the equivalent dose of levodopa were higher than those in the non-sleep disordered group,the differences were statistically significant(P<0.05).Multifactorial regression analysis showed that total sleep time(OR=0.738,95%CI:0.599-0.908)was a protective factor for Parkinson's disease sleep disorder,and chronic pain(OR=3.165,95%CI:1.198-2.783)and levodopa equivalent dose(OR=3.165,95%CI:1.436-6.972)were PD sleep disorder risk factors(P<0.05).PDQ-39,PDNMS,HAMA,and HAMD scores were higher in the sleep-disordered group than those in the non-sleep disordered group,the differences were statistically significant(P<0.05).Correlation analysis

关 键 词：帕金森病 睡眠障碍 影响因素 生活质量 非运动症状 心理状态 

分 类 号：R740[医药卫生—神经病学与精神病学] R742.5[医药卫生—临床医学]