帕金森病患者日间过度思睡相关因素的分析

发布时间：2018-04-08 14:38

  本文选题：帕金森病　切入点：日间过度思睡　出处：《大连医科大学》2017年硕士论文

【摘要】：目的:日间过度思睡(excessive daytime sleepiness,EDS)是帕金森病患者常见非运动症状之一。本研究的目的是评估帕金森病患者日间过度思睡情况,并分析其与年龄、性别、运动系统症状、服药情况、夜间睡眠情况及情感状况等因素的相关性。方法:连续收集大连医科大学附属第二医院2015年01月01日-2016年12月31日神经内科住院及门诊就诊符合入组标准的帕金森病患者112例组成帕金森病组,120例在年龄、性别上相匹配的健康人组成为对照组。采用爱泼沃斯思睡量表(Epworth sleepiness scale,ESS)评定日间过度思睡(EDS)情况,比较帕金森病组与健康对照组的EDS发生情况。根据ESS评分将帕金森患者分为EDS组(ESS≥10分)和非EDS组(ESS10分),并对两组间在年龄、性别、病程、疾病严重程度、情感状态、夜间睡眠情况及服用药物史等相关因素进行分析。从中选取具有统计学意义(P0.05)的因素进行Logistic回归分析,从而找出EDS发生的独立危险因素。结果:一、一般资料本研究包括112例PD患者,男性62例(55.36%),女性50例(44.64%),平均年龄在68.82±8.82岁。对照组男性60例(50.00%),女性60例(50.00%),平均年龄在66.70±10.33。PD组患者中有44例(39.28%)ESS≥10分,健康对照组有16例(13.33%)ESS≥10分,两组差异有统计学意义(P0.05)。二、EDS相关因素分析1、EDS组男性(59.09%)比非EDS组男性(52.94%)比例大,在病程上EDS组(5.06±2.65年)要比非EDS组病程长(4.71±3.53年),但两组间比较没有统计学意义(P0.05)。2、EDS组与非EDS组比较,在年龄、HAMD评分、Hoehn-Yahr评分、UPDRS-Ⅲ评分、PSQI评分、是否服用多巴胺受体激动剂及左旋多巴药物剂量比较差异有统计学差异(P0.05)。3.将上述分析中具有统计学意义的因素进行多因素回归分析结果显示,HAMD评分(OR=1.221,95%CI 1.006-1.483),左旋多巴等效剂量(OR=1.009,95%CI1.003-1.015)及是否服用多巴胺受体激动剂(OR=5.475,95%CI 1.094-27.398)以上3个变量有统计学差异(P0.05)。结论:一、帕金森患者日间过度思睡发生率为39.28%,明显高于健康对照组。二、通过本次研究,发现患者的抑郁情况、是否应用多巴胺受体激动剂及多巴胺药物剂量可能是日间过度思睡发生的独立危险因素。三、临床工作中,对药物选择要谨慎,特别是左旋多巴药物剂量应用较大及联合多巴胺受体激动剂时,观察日间过度思睡情况,防止出现危险。
[Abstract]:Objective: excessive daytime sleepiness (EDS) is one of the common non-motor symptoms in patients with Parkinson's disease.The purpose of this study was to evaluate the daytime overthinking of sleep in patients with Parkinson's disease and to analyze its correlation with age, sex, motor system symptoms, medication, night sleep and emotional status.Methods: one hundred and twelve patients with Parkinson's disease in the second affiliated Hospital of Dalian Medical University from January 01, 2015 to December 31, 2016, who were admitted to the Department of Neurology and outpatient Service, were collected. 120 patients with Parkinson's disease were enrolled in this study.Sex matched healthy persons were used as control group.Epworth sleepiness scale (ESSs) was used to evaluate the incidence of EDS in patients with Parkinson's disease (PD) and healthy controls.According to ESS score, Parkinson's patients were divided into EDS group (ESS 鈮，

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