目的 研究原发性震颤(ET)患者、帕金森病(PD)患者和健康对照组的睡眠障碍发生率及临床特征的差异性.方法 2009年6月至2013年12月采用匹兹堡睡眠质量指数(PSQI)、爱泼沃斯思睡量表(ESS)对苏州大学附属第二医院、江苏省常熟市中医院门诊确诊为ET的患者62例(男29例,女33例)、PD患者62例(男30例,女32例)、健康对照组60名(男28名,女32名)的睡眠状况进行评估.结果 健康对照组PSQI得分为(4.7±2.5)分,ET组PSQI得分为(6.0±4.0)分,PD组得分为(7.8±3.7)分,三组比较(F=9.022,P=0.000)差异有统计学意义,进一步比较ET、PD两组PSQI评分差异有统计学意义(P＜0.05).PSQI＞5分者,健康对照组23名(38.3％),ET组有34例(54.8％),PD组有40例(64.5％),三组比较差异有统计学意义(x2=8.555,P=0.014),ET、PD两组睡眠障碍发生率对比差异无统计学意义(x2=1.206,P=0.272);ESS评分健康对照组得分为(4.4±2.5)分,ET组得分为(6.3±4.8)分,PD组得分为(8.2±4.2)分;三组比较(F=13.924,P=0.000)差异有统计学意义;ESS≥10分者,健康对照组6名(10.0％),ET组有16例(25.8％),PD组有20例(32.3％),三组比较,EDS发生率差异有统计学意义(x2 =9.047,P=0.011),ET、PD两组EDS发生率差异无统计学意义(x2=0.626,P=0.429).健康对照组、ET组、PD组三组PSQI各因子比较结果:主观睡眠质量得分为(0.6±0.7)分、(0.8±0.8)分和(1.1±0.7)分,入睡时间得分为(0.6±0.7)分、(0.9±0.9)分和(1.1±1.0)分,睡眠时间得分为(0.6±0.8)分、(0.7±1.0)分和(1.0±0.9)分,睡眠效率得分为(0.6±0.8)分、(0.9±0.9)分和(1.0±1.0)分,睡眠干扰得分为(1.2±0.6)分、(1.2±0.5)分和(1.7±0.7)分,及日间功能得分为(1.2±1.0)分、(1.3±1.0)分和(2.0±1.1)分,差异均有统计学意义(均P＜0.05),而催眠药物得分差异无统计学意义(P＞0.05);迸一步两两比较ET组与PD组PSQI各因子比较结果:两组主观睡眠质量得分为(0.8±0.8)分和(1.1±0.7)分、睡眠干扰得分(1.2±0.5)分和(1.7±0.7)分、日间功能得分(1.3±1.0)分和(2.0±1.1)分差异有统计学意义(P＜0.05),而两组人睡时间、睡眠时间、睡眠效率及催眠药物得分差异无统计学意义(P＞0.05).结论 ET患者睡眠障碍发生率同PD患者相似,临床主要表现为人睡困难、片断睡眠及日间过度思睡,ET患者的总体睡眠质量、主观睡眠质量、日间过度思睡介于健康对照组和PD患者之间,程度轻于PD患者.
目的 研究原髮性震顫(ET)患者、帕金森病(PD)患者和健康對照組的睡眠障礙髮生率及臨床特徵的差異性.方法 2009年6月至2013年12月採用匹玆堡睡眠質量指數(PSQI)、愛潑沃斯思睡量錶(ESS)對囌州大學附屬第二醫院、江囌省常熟市中醫院門診確診為ET的患者62例(男29例,女33例)、PD患者62例(男30例,女32例)、健康對照組60名(男28名,女32名)的睡眠狀況進行評估.結果 健康對照組PSQI得分為(4.7±2.5)分,ET組PSQI得分為(6.0±4.0)分,PD組得分為(7.8±3.7)分,三組比較(F=9.022,P=0.000)差異有統計學意義,進一步比較ET、PD兩組PSQI評分差異有統計學意義(P＜0.05).PSQI＞5分者,健康對照組23名(38.3％),ET組有34例(54.8％),PD組有40例(64.5％),三組比較差異有統計學意義(x2=8.555,P=0.014),ET、PD兩組睡眠障礙髮生率對比差異無統計學意義(x2=1.206,P=0.272);ESS評分健康對照組得分為(4.4±2.5)分,ET組得分為(6.3±4.8)分,PD組得分為(8.2±4.2)分;三組比較(F=13.924,P=0.000)差異有統計學意義;ESS≥10分者,健康對照組6名(10.0％),ET組有16例(25.8％),PD組有20例(32.3％),三組比較,EDS髮生率差異有統計學意義(x2 =9.047,P=0.011),ET、PD兩組EDS髮生率差異無統計學意義(x2=0.626,P=0.429).健康對照組、ET組、PD組三組PSQI各因子比較結果:主觀睡眠質量得分為(0.6±0.7)分、(0.8±0.8)分和(1.1±0.7)分,入睡時間得分為(0.6±0.7)分、(0.9±0.9)分和(1.1±1.0)分,睡眠時間得分為(0.6±0.8)分、(0.7±1.0)分和(1.0±0.9)分,睡眠效率得分為(0.6±0.8)分、(0.9±0.9)分和(1.0±1.0)分,睡眠榦擾得分為(1.2±0.6)分、(1.2±0.5)分和(1.7±0.7)分,及日間功能得分為(1.2±1.0)分、(1.3±1.0)分和(2.0±1.1)分,差異均有統計學意義(均P＜0.05),而催眠藥物得分差異無統計學意義(P＞0.05);迸一步兩兩比較ET組與PD組PSQI各因子比較結果:兩組主觀睡眠質量得分為(0.8±0.8)分和(1.1±0.7)分、睡眠榦擾得分(1.2±0.5)分和(1.7±0.7)分、日間功能得分(1.3±1.0)分和(2.0±1.1)分差異有統計學意義(P＜0.05),而兩組人睡時間、睡眠時間、睡眠效率及催眠藥物得分差異無統計學意義(P＞0.05).結論 ET患者睡眠障礙髮生率同PD患者相似,臨床主要錶現為人睡睏難、片斷睡眠及日間過度思睡,ET患者的總體睡眠質量、主觀睡眠質量、日間過度思睡介于健康對照組和PD患者之間,程度輕于PD患者.
목적 연구원발성진전(ET)환자、파금삼병(PD)환자화건강대조조적수면장애발생솔급림상특정적차이성.방법 2009년6월지2013년12월채용필자보수면질량지수(PSQI)、애발옥사사수량표(ESS)대소주대학부속제이의원、강소성상숙시중의원문진학진위ET적환자62례(남29례,녀33례)、PD환자62례(남30례,녀32례)、건강대조조60명(남28명,녀32명)적수면상황진행평고.결과 건강대조조PSQI득분위(4.7±2.5)분,ET조PSQI득분위(6.0±4.0)분,PD조득분위(7.8±3.7)분,삼조비교(F=9.022,P=0.000)차이유통계학의의,진일보비교ET、PD량조PSQI평분차이유통계학의의(P＜0.05).PSQI＞5분자,건강대조조23명(38.3％),ET조유34례(54.8％),PD조유40례(64.5％),삼조비교차이유통계학의의(x2=8.555,P=0.014),ET、PD량조수면장애발생솔대비차이무통계학의의(x2=1.206,P=0.272);ESS평분건강대조조득분위(4.4±2.5)분,ET조득분위(6.3±4.8)분,PD조득분위(8.2±4.2)분;삼조비교(F=13.924,P=0.000)차이유통계학의의;ESS≥10분자,건강대조조6명(10.0％),ET조유16례(25.8％),PD조유20례(32.3％),삼조비교,EDS발생솔차이유통계학의의(x2 =9.047,P=0.011),ET、PD량조EDS발생솔차이무통계학의의(x2=0.626,P=0.429).건강대조조、ET조、PD조삼조PSQI각인자비교결과:주관수면질량득분위(0.6±0.7)분、(0.8±0.8)분화(1.1±0.7)분,입수시간득분위(0.6±0.7)분、(0.9±0.9)분화(1.1±1.0)분,수면시간득분위(0.6±0.8)분、(0.7±1.0)분화(1.0±0.9)분,수면효솔득분위(0.6±0.8)분、(0.9±0.9)분화(1.0±1.0)분,수면간우득분위(1.2±0.6)분、(1.2±0.5)분화(1.7±0.7)분,급일간공능득분위(1.2±1.0)분、(1.3±1.0)분화(2.0±1.1)분,차이균유통계학의의(균P＜0.05),이최면약물득분차이무통계학의의(P＞0.05);병일보량량비교ET조여PD조PSQI각인자비교결과:량조주관수면질량득분위(0.8±0.8)분화(1.1±0.7)분、수면간우득분(1.2±0.5)분화(1.7±0.7)분、일간공능득분(1.3±1.0)분화(2.0±1.1)분차이유통계학의의(P＜0.05),이량조인수시간、수면시간、수면효솔급최면약물득분차이무통계학의의(P＞0.05).결론 ET환자수면장애발생솔동PD환자상사,림상주요표현위인수곤난、편단수면급일간과도사수,ET환자적총체수면질량、주관수면질량、일간과도사수개우건강대조조화PD환자지간,정도경우PD환자.
Objective To evaluate the sleep quality and explore the manifestations of sleep disorders for 62 essential tremor (ET) patients,60 normal controls and 62 Parkinson's disease (PD) patients.Methods A total of 62 ET patients,60 normal controls and 62 PD patients from June 2009 to December 2013 were recruited.All of them were outpatients at Second Affiliated Hospital,Soochow University and Hospital of Changshu Hospital of Traditional Chinese Medicine.Sleep was assessed with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS).Results The global PSQI score was 4.7±2.5 in controls,6.0±4.0 in ET cases and 7.4±3.7 in PD cases.PD cases had the highest PSQI score,followed by ET (intermediate) and lowest scores in controls (F =9.022,P =0.000).A poor quality of sleep was observed in normal controls (23/62,38.3％) compared to ET cases (34/62,54.8％) and PD cases (40/62,64.5％) (x2 =8.555,P =0.014 when comparing all three groups and x2 =1.206,P =0.272 when ET vs PD).The ESS score increased from normal controls (4.4 ± 2.5) to ET cases (6.3 ± 4.8) and PD cases (8.2 ± 4.2).An ESS score ≥ 10 (an indicator of greater than normal levels of daytime sleepiness) was observed in 6 (10.0％) normal controls,compared to ET cases (16,25.8％) and PD cases (20,32.3％) (x2 =9.047,P =0.011 when comparing all three groups and x2 =0.626,P =0.429 when ET vs PD).For normal controls,ET and PD patients,the factor scores of subjective sleep were 0.6 ± 0.7,0.8 ± 0.8 and 1.1 ± 0.7 ; the factor scores of quality sleep latency 0.6 ± 0.7,0.9 ± 0.9 and 1.1 ± 1.0 ; the factor scores of sleep duration 0.6 ± 0.8,0.7 ± 1.0 and 1.0 ± 0.9 ; the factor scores of sleep efficiency 0.6 ± 0.8,0.9 ± 0.9 and 1.0 ± 1.0 ; the factor scores of sleep disturbances 1.2 ± 0.6,1.2 ± 0.5 and 1.7 ± 0.7 ; the factor scores of daytime dysfunction 1.2 ± 1.0,1.3 ± 1.0 and 2.0 ± 1.1 respectively.There were inter-group statistical differences in subjective sleep (F =7.709,P =0.001),quality sleep latency(F =4.414,P =0.013),sleep duration (F =4.464,P =0.013),sleep efficiency (F =3.201,P =0.043),sleep disturbances (F =12.594,P =0.000) and daytime dysfunction (F =9.022,P =0.000).However,no inter-group statistical differences existed in use of sleeping medication (F =1.200,P =0.304).There were statistical differences in subjective sleep (P ＜ 0.05),sleep efficiency (P ＜ 0.05) and daytime dysfunction (P ＜ 0.05) between ET and PD patients.Conclusion Some sleep scores in ET are intermediate between those of PD cases and normal controls.And it suggests that a mild form of sleep dysregulation may be present in ET.
