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目的研究帕金森病患者睡眠障碍发生及其特点和影响因素。方法收集患者病史资料并应用多导睡眠仪对10例帕金森病患者及5名健康对照进行多导睡眠监测。受试者分为3组:对照组、帕金森病Hoehn-Yahr(H&Y)Ⅰ级组及帕金森病H&YⅡ~Ⅳ级组。每组均包括男性3例,女性2例。结果3组年龄分别为(54·4±5·7)岁、(57·6±14·5)岁、(58·2±10·7)岁,年龄之间的差异无统计学意义(F=0·232,P=0·794)。对照组浅慢波睡眠时间为(70·6±7·8)min,而H&YⅠ级组患者浅慢波睡眠时间为(81·4±6·1)min,显著高于对照组(P=0·008);对照组睡眠效率为75·6%±12·8%,快动眼睡眠(REM)潜伏期为(116±48)min,浅慢波睡眠所占比例为70·6%±7·8%,REM所占比例为14·8%±5·5%,总睡眠时间为(372·8±53·4)min,而H&YⅡ~Ⅳ级组患者睡眠效率43·6%±16·0%(P=0·003)、REM所占比例7·3%±6·1%(P=0·003)及总睡眠时间(244·3±103·2)min(P=0·006)均显著低于对照组,REM睡眠潜伏期(281±86)min(P=0·000)及浅慢波睡眠时间(85·3±7·9)min(P=0·000)显著高于对照组。经相关分析,睡眠潜伏期、浅慢波睡眠时间与疾病病程存在显著正相关(r分别为0·889、0·492;P值分别为0·000、0·006),而睡眠效率、深慢波睡眠时间及总睡眠时间与疾病病程有显著负相关(r分别为-0·626、-0·723、-0·728;P值均为0·000)。结论研究结果显示,帕金森病患者在患病早期已经存在夜间睡眠时间减少、睡眠效率下降、睡眠潜伏期延长及睡眠结构的改变等异常,而且有随疾病进展而加重的趋势。
Objective To study the occurrence of sleep disorders and its characteristics and influencing factors in patients with Parkinson’s disease. Methods The patient history data were collected and polysomnography was performed on 10 patients with Parkinson’s disease and 5 healthy controls using polysomnography. Subjects were divided into 3 groups: control group, Parkinson’s disease Hoehn-Yahr (H & Y) Ⅰ group and Parkinson’s disease H & Y Ⅱ ~ Ⅳ group. Each group includes 3 males and 2 females. Results The three groups were (54.4 ± 5.7) years old, (57.6 ± 14.5) years old, (58.2 ± 10.7) years old, with no significant difference in age (F = 0 · 232, P = 0 · 794). The time of shallow and slow wave sleep in control group was (70.6 ± 7.8) min, while that in H & Y Ⅰ group was (81.4 ± 6.1) min, which was significantly higher than that in control group (P = 0 · 008). The sleep efficiency of the control group was 75.6% ± 12.8%, the latency of REM sleep was 116 ± 48 minutes, the rate of shallow sleep was 70.6% ± 7% 8%, REM accounted for 14.8% ± 5.5%, total sleep time was (372.8 ± 53.4) min, while H & YⅡ ~ Ⅳ group sleep efficiency of 43.6% ± 16.0 (P = 0.003), the proportion of REM accounted for 7.3% ± 6.1% (P = 0.003) and total sleep time (244.3 ± 103.2) min (P = 0.006) Were significantly lower than that of the control group (REM) (281 ± 86) min (P = 0.000) and shallow and slow sleep time (85.3 ± 7.9) min (P = 0.000) group. Correlation analysis showed that there was a significant positive correlation between sleep latency and shallow and slow wave sleep duration and disease duration (r = 0.889 and 0.492, P = 0.00 and 0.06, respectively), while sleep efficiency Wave sleep time and total sleep time were significantly and negatively correlated with the course of the disease (r = -0.662, -0.723, -0.782, respectively; all P values were -0.000). Conclusions The results showed that Parkinson’s disease patients had abnormalities such as decreased nighttime sleepiness, decreased sleep efficiency, prolonged sleep latency and changes in sleep structure in the early stage of their illness, and also increased with the progression of the disease.