CAJ | 학술논문

目的研究快速眼动(REM)期睡眠行为障碍(RBD)在突触核蛋白病中的出现率、出现时间、电生理特点,探讨RBD与突触核蛋白病之间的关系以及电生理诊断指标.方法通过对患者的睡眠状况调查以及夜间多导睡眠监测(NPSG),研究本组疾病的睡眠障碍特征:(1)主观睡眠调查:帕金森病(PD)患者66例,多系统萎缩(MSA)患者30例,性别、年龄匹配的健康对照组65名,询问睡眠史,了解RBD出现的比例及出现时间.(2)NPSG:PD组8例、MSA组13例,健康对照组15名,所有受试者行连续两夜NPSG监测.分析伴发RBD的突触核蛋白病患者的NPSG特点.结果 PD和MSA合并RBD比例分别是59.1%(39/66)和86.6%(26/30),明显高于对照组(4.6%,3/65),其中RBD早于两种变性病临床发病的患者比例分别是46.2%(18/39)和84.6%(22/26).PD和MSA合并RBD最主要的NPSG特点是:REM期肌肉弛缓现象消失(RWA)和运动增多.RWA比例和位相性肌电活动密度可能成为神经变性病合并RBD的NPSG诊断指标.结论 RBD在PD和MSA患者中出现率明显增高,部分RBD发生先于变性病,提示RBD与突触核蛋白病关系密切,RBD有可能是突触核蛋白病的早期表现.NPSG特征应作为RBD的主要诊断标准,RWA比例和位相性肌电活动密度可能成为神经变性病合并RBD的NPSG诊断指标.
목적 연구쾌속안동(REM)기수면행위장애(RBD)재돌촉핵단백병중적출현솔、출현시간、전생리특점,탐토RBD여돌촉핵단백병지간적관계이급전생리진단지표.방법 통과대환자적수면상황조사이급야간다도수면감측(NPSG),연구본조질병적수면장애특정:(1)주관수면조사:파금삼병(PD)환자66례,다계통위축(MSA)환자30례,성별、년령필배적건강대조조65명,순문수면사,료해RBD출현적비례급출현시간.(2)NPSG:PD조8례、MSA조13례,건강대조조15명,소유수시자행련속량야NPSG감측.분석반발RBD적돌촉핵단백병환자적NPSG특점.결과 PD화MSA합병RBD비례분별시59.1%(39/66)화86.6%(26/30),명현고우대조조(4.6%,3/65),기중RBD조우량충변성병림상발병적환자비례분별시46.2%(18/39)화84.6%(22/26).PD화MSA합병RBD최주요적NPSG특점시:REM기기육이완현상소실(RWA)화운동증다.RWA비례화위상성기전활동밀도가능성위신경변성병합병RBD적NPSG진단지표.결론 RBD재PD화MSA환자중출현솔명현증고,부분RBD발생선우변성병,제시RBD여돌촉핵단백병관계밀절,RBD유가능시돌촉핵단백병적조기표현.NPSG특정응작위RBD적주요진단표준,RWA비례화위상성기전활동밀도가능성위신경변성병합병RBD적NPSG진단지표.
Objective To investigate the incidence rate, onset time and electrophysiological characteristics of rapid eye movement sleep behavior disorder (RBD) and the relationship between RBD and synucleinopathies as well as the electrophysiological diagnostic criteria of RBD in Parkinson' s disease (PD) and multiple system atrophy (MSA). Methods Sleep survey and night video-polysomnography (NPSG)were used to study sleep disturbance of PD and MSA. (1) Subjective sleep assessments: All subjects,including 66 PD patients, 65 age and sex matched healthy controls and 30 MSA patients, completed the sleep questionnaires, and the RBD incidence rate and onset time were got. (2) Objective sleep assessments: 8 PD patients, 13 MSA patients, and 15 age and sex matched healthy controls underwent video-NPSG recording on two consecutive nights. Sleep architect were analyzed. The NPSG characteristics of RBD accompany with PD and MSA were analyzed, and the electrophysiological diagnostic varameters of it were determined. Results Patients with PD or MSA had a higher prevalence of RBD. RBD was found in 59. 1% (39/66) PD patients and 86. 6% (26/30) MSA patients, among those, 46. 2% ( 18/39 ) and 84.6% (22/26) had the waking symptoms of MSA and PD. The main NPSG characteristics of RBD of PD or MSA were chin REM without atonia (RWA) and increased movement. Conclusions The relatively higher RBD prevalence in MSA and PD patients indicates that RBD has close relationship with PD and MSA.Part of patients with RBD preceding neurology disease indicates that RBD may be the early marker of PD and MSA. The main NPSG characteristics of RBD accompany with PD and MSA are chin RWA and the motor manifestations. RWA and phasic EMG activity density are supposed to be the NPSG diagnostic parameters.