CAJ | 학술논문

目的评价帕金森病合并快速眼球运动睡眠行为障碍(RBD)患者的睡眠结构及认知功能,并探讨其睡眠结构与认知功能之间的相关性.方法本研究为横断面研究,以在我院睡眠中心进行睡眠监测的39例帕金森病合并RBD患者作为病例组,并以年龄、性别相匹配的21例原发性快速眼球运动睡眠行为障碍(iRBD)患者及37例不合并RBD的帕金森病患者作为对照组.所有患者均行整夜睡眠监测以定量睡眠相关参数,并且于监测当天使用蒙特利尔(MoCA)评估量表评估其认知功能.采用多重线性回归分析量表得分与睡眠结构之间的相关性.结果 (1)帕金森病合并RBD患者的睡眠效率(60.9％±16.9％)、总睡眠时间[(329.7±96.5)min]、非快速眼动睡眠2期时间[(127.6±67.6) min]及快速眼动睡眠期时间[(45.3 ±33.2) min]较iRBD组的相应值[77.8％±16.9％以及(397.1 ±88.9)、(188.0±94.7)、(70.6 ±25.9) min]比较明显减少(均P＜0.05),较不合并RBD的PD组的相应值[61.3％±21.7％以及(324.9 ±134.6)、(132.6 ±65.6)、(47.1±31.9)min]减少,但差异均无统计学意义.3组的睡眠潜伏期、快速眼球运动睡眠潜伏期、非快速眼球运动睡眠1期,慢波睡眠比例、氧减指数、呼吸暂停低通气指数及周期性肢体运动指数比较差异均无统计学意义.(2)帕金森病合并RBD患者认知功能最差,其中视空间与执行功能得分[(3.8±1.1)分]较iRBD组[(4.4±0.7)分]比较差异有统计学意义(F=3.426,P＜0.05).(3)多重线性回归显示帕金森病合并RBD患者的RBD病程、睡眠效率和非快速眼动睡眠2期与视空间与执行功能得分有相关性.结论帕金森病合并RBD患者的睡眠效率、总睡眠、非快速眼动睡眠2期及快速眼动睡眠期时间和认知功能均明显下降,认知功能的改变与睡眠结构的变化可能存在相关性.
목적 평개파금삼병합병쾌속안구운동수면행위장애(RBD)환자적수면결구급인지공능,병탐토기수면결구여인지공능지간적상관성.방법 본연구위횡단면연구,이재아원수면중심진행수면감측적39례파금삼병합병RBD환자작위병례조,병이년령、성별상필배적21례원발성쾌속안구운동수면행위장애(iRBD)환자급37례불합병RBD적파금삼병환자작위대조조.소유환자균행정야수면감측이정량수면상관삼수,병차우감측당천사용몽특리이(MoCA)평고량표평고기인지공능.채용다중선성회귀분석량표득분여수면결구지간적상관성.결과 (1)파금삼병합병RBD환자적수면효솔(60.9％±16.9％)、총수면시간[(329.7±96.5)min]、비쾌속안동수면2기시간[(127.6±67.6) min]급쾌속안동수면기시간[(45.3 ±33.2) min]교iRBD조적상응치[77.8％±16.9％이급(397.1 ±88.9)、(188.0±94.7)、(70.6 ±25.9) min]비교명현감소(균P＜0.05),교불합병RBD적PD조적상응치[61.3％±21.7％이급(324.9 ±134.6)、(132.6 ±65.6)、(47.1±31.9)min]감소,단차이균무통계학의의.3조적수면잠복기、쾌속안구운동수면잠복기、비쾌속안구운동수면1기,만파수면비례、양감지수、호흡잠정저통기지수급주기성지체운동지수비교차이균무통계학의의.(2)파금삼병합병RBD환자인지공능최차,기중시공간여집행공능득분[(3.8±1.1)분]교iRBD조[(4.4±0.7)분]비교차이유통계학의의(F=3.426,P＜0.05).(3)다중선성회귀현시파금삼병합병RBD환자적RBD병정、수면효솔화비쾌속안동수면2기여시공간여집행공능득분유상관성.결론 파금삼병합병RBD환자적수면효솔、총수면、비쾌속안동수면2기급쾌속안동수면기시간화인지공능균명현하강,인지공능적개변여수면결구적변화가능존재상관성.
Objective To evaluate the sleep structure and cognitive function in Parkinson's disease (PD) patients with rapid eye movement (REM) sleep behavior disorder (RBD),and then explore the correlation between sleep structure and cognitive function in PD patients with RBD.Methods It was a cross-sectional study.Ninety-seven patients in our sleep center,including 39 PD patients with RBD and 21 age-and sex-matched idiopathic RBD (iRBD) patients (control group),37 PD patients without RBD (control group),underwent video-polysomnography to acquire sleep parameters.Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) on the same day.A multiple linear regression model was used to find the score of cognition correlated with sleep structure.Results (1) The sleep efficiency,total sleep time,non-rapid eye movement (NREM)2 and REM sleep time were all significantly decreased in PD patients with RBD than those in iRBD patients (60.9％ ± 16.9％ vs 77.8％ ± 16.9％,(329.7±96.5) min vs (397.1±88.9) min,(127.6 ±67.6) min vs (188.0 ±94.7) min,(45.3±33.2) min vs (70.6 ± 25.9) min,all P ＜ 0.05),respectively.There were no significant differences of these above parameters compared to PD patients without RBD(61.3％ ± 21.7％,(324.9 ± 134.6) min,(132.6 ± 65.6) min,(47.1 ± 31.9) min).There was no statistical significance in sleep latency,REMsleep latency,NREM1 time,the percentage of slow wave sleep,oxygen desaturation index,apnea hyponea index and periodic leg movement in sleep among three groups.(2) PD patients with RBD had the lowest MoCA scores.The score of visuospatial and executive function in PD patients with RBD was lower than that in iRBD (3.8 ± 1.1 vs 4.4 ± 0.7 ; F =3.426,P ＜ 0.05).(3) Multiple linear regression analysis showed that there was correlation between the score of visuospatial and executive functions and the course of RBD,sleep efficiency and NREM2 in PD patients with RBD.Conclusions The PD patients with RBD have the worst sleep efficiency and cognitive function,the shortest total sleep time,NREM2 and REM sleep time.The cognitive impairment may be correlated with the change of sleep structure.