帕金森病患者抑郁对睡眠、认知功能的影响  

Effects of depression on sleep and cognitive function in patieuts with Parkinson's disease

作　　者：朱晓冉 李秀华 任延红 毛飞 方雨晴 赵张宁 王雅琳 刘天淏 张艳青 韩润冬 ZHU Xiaoran;LI Xiuhua;REN Yanhong;MAO Fei;FANG Yuqing;ZHAO Zhangning;WANG Yalin;LIU Tianhao;ZHANG Yanqing;HAN Rundong(School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,Shandong,China;Department of Neurology,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,Shandong,China)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261053 [2]山东第一医科大学第一附属医院神经内科,山东济南250014

出　　处：《山东大学学报(医学版)》2025年第3期63-70,共8页Journal of Shandong University:Health Sciences

摘　　要：目的探究帕金森病(Parkinson?s disease,PD)患者抑郁对睡眠及认知功能的影响。方法选取2018年至2023年就诊的PD患者136例,根据汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分分为PD伴抑郁组(n=93)和PD不伴抑郁组(n=43)。收集两组帕金森病睡眠量表(Parkinson?s disease sleep scale,PDSS)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)等相关临床量表及多导睡眠监测等数据。采用Wilcoxon秩和检验评估PD伴抑郁组和PD不伴抑郁组各睡眠及认知相关量表等数据的差异;采用Spearman等级相关分析对抑郁与睡眠及认知功能的相关性进行分析;采用多元线性回归分析PD抑郁的危险因素。结果PD伴抑郁组日间过度嗜睡评定量表(epworth sleepiness scale,ESS)评分、生活质量评分等高于PD不伴抑郁组,PDSS评分及MoCA评分低于PD不伴抑郁组,PD伴抑郁组的入睡潜伏期长于PD不伴抑郁组,差异有统计学意义(P<0.05)。HAMD、MoCA及睡眠情况各项评分呈显著相关(P<0.05)。多元线性回归分析结果示焦虑及生活质量对PD抑郁有一定的预测价值(P<0.05)。结论在PD患者中,抑郁症状越重,其睡眠障碍、认知功能障碍越严重,生活质量越受影响。Objective To investigate the impact of depression on sleep and cognitive function in patients with Parkinson's disease(PD).Methods A total of 136 patients diagnosed with PD and hospitalised between 2018 and 2023 were carefully identified and categorised into PD with depression group(n=93)and PD without depression group(n=43),according to their Hamilton depression scale(HAMD)score.We collected sleep and cognition scale,such as Parkinson's disease sleep scale(PDSS),Montreal cognitive assessment(MoCA)and other clinical scales and polysomnography in the two groups.The Wilcoxon rank-sum test was used to assess discrepancies in sleep and cognitive metrics between the PD with depression group and the PD without depression group;the relationship between depression,cognitive function,and sleep quality was examined by Spearman rank correlation analysis;the risk factors associated with PD-related depression were examined by multiple linear regression analysis.Results ESS score and PDQ-39 scores in the PD with depression group were higher than those in the PD without depression group,whereas PDSS scores and MoCA scores were lower in the PD with depression group.Sleep latency in the PD with depression group was longer than that in the PD without depression group,and the differences were statistically significant(P<0.05).Depression scores were significantly correlated with MoCA and various sleep state scores(P<0.05).Multiple linear regression analysis showed that anxiety and quality of life had some predictive value for PD depression(P<0.05).Conclusion In PD patients,the more severe the depressive symptoms,the more severe the sleep disturbance and cognitive impairment,and the more impaired the quality of life.

关 键 词：帕金森病 抑郁 睡眠障碍 认知功能 生活质量 

分 类 号：R742.5[医药卫生—神经病学与精神病学]