帕金森病伴不宁腿综合征临床研究

Clinical study on restless legs syndrome in Parkinson disease

目的分析帕金森病伴不宁腿综合征的发病率及临床特征，以探讨帕金森病与不宁腿综合征之间的关系。方法107例帕金森病患者，14例（13．08％）伴不宁腿综合征，93例（86．92％）不伴不宁腿综合征，对其运动功能、日常生活活动能力、疾病严重程度、抑郁及睡眠质量进行评价。结果帕金森病伴不宁腿综合征患者年龄低于不伴不宁腿综合征者（t=2．199，P=0．028），而病程、运动功能、日常生活活动能力、疾病严重程度、抑郁、睡眠质量及抗帕金森病药物剂量，组问差异无统计学意义（均P〉0．05）。帕金森病伴不宁腿综合征患者帕金森病睡眠量表第4项（t=2．051，P=0．018）和第12项（t=1．954，P=0．046）评分均低于不伴不宁腿综合征者。两组Epworth嗜睡量表评分异常者比较，差异无统计学意义（p=0．376）。结论不宁腿综合征在帕金森病患者中的发病率高于正常人群，二者之间存在一定的联系，可能具有共同的发病机制。不宁腿综合征是加重帕金森病患者睡眠障碍的重要原因之一。

Objective To analysis the morbidity and clinical characteristics of restless legs syndrome （RLS） in patients with Parkinson disease （PD）, and to explore the causal relationship between RLS and PD. Methods One hundred and seven patients with PD, 14 cases （13.08%） with RLS, and 93 cases （86.92%） without RLS were studied. Unified Parkinson Disease Rating Scale Ⅱ -Ⅳ （UPDRS Ⅱ -Ⅳ）, Activities of Daily Living Scale （ADL）, Hoehn-Yahr Scale, Hamilton Depression Rating Scale （HAMD）, Parkinson Disease Sleep Scale （PDSS）, and Epworth Sleepiness Scale （ESS） were used to assess the motor function, daily life activities, severity of disease, depression and quality of sleep. Results The PD patients with RLS were younger than those without RLS （t=2.199, P=0.028）. There were no significant differences in duration, UPDRS Ⅱ-Ⅳ scores, ADL score, Hoehn-Yahr Scale, HAMD score, PDSS score, ESS score, and the dose of dopamine and other drugs used for Parkinson disease between 2 groups （P〉 0.05, for all）. The PD patients with RLS had lower scores in item 4 （t = 2.051, P= 0.018） and item 12 （t = 1.954, P= 0.046） in the PDSS than those without RLS. Six patients out of 14 （42.86%） with RLS had abnormal scores in the ESS, 29 patients out of 93 （31.18%） without RLS had abnormal scores, and there was no significant difference between them （P= 0.376）. Conclusion RLS is more frequently seen in patients with PD. The 2 disorders may share the same pathophysiological mechanism. RLS may play an important role in sleep dysfunction in PD patients.