睡眠质量对轻中度帕金森病患者认知功能的影响

Effect of sleep quality on cognitive function in mild-to-moderate Parkinson patients

目的 探讨睡眠质量对轻中度帕金森病患者认知功能的影响.方法 选取71例PD患者为研究对象,采用简易精神状态检查量表（MMSE）和蒙特利尔认知评估表（MoCA,北京版）评定患者的认知功能,匹兹堡睡眠质量指数（PSQI）评定患者的认知功能,比较不同睡眠情况患者的认知水平和不同认知水平患者的睡眠质量,以及两者之间的相关性.结果 71例PD患者均为轻中度PD患者,其中出现睡眠障碍的患者有37例（52.1％）.睡眠障碍组统一帕金森评分量表（UPDRS）评分为（45.7±15.9）分高于睡眠正常组（35.8±13.8）分,MoCA（20.5±5.3）分和MMSE（25.7±3.3）分低于睡眠正常组（23.7±4.2）,（27.5±2.6）分,差异均有统计学意义（P＜0.05）.49例（69.0％）患者出现认知功能障碍,其中轻度认知功能障碍28例（39.4％）,痴呆21例（29.6％）.痴呆组MMSE评分为（23.0±1.7）分,为轻度痴呆.PD伴痴呆患者睡眠质量差,PSQI（8.9±4.5）分高于认知功能正常组（5.2±3.3）分,差异有统计学意义（P＜0.01）.存在睡眠障碍的PD患者认知障碍患病率高（P＜0.05）.结论 轻中度PD患者睡眠障碍发生率高.病情的严重程度影响PD患者的睡眠质量,病情重的PD患者,睡眠障碍的发生率高.睡眠质量差的PD患者认知功能减退,伴痴呆的PD患者的睡眠质量更差.

Objective To explore the sleep quality effects on cognitive function in mild-to-moderate Parkinson patients. Methods Totals of 71 cases of Parkinson disease were included. Minimum Mental State Examination（MMSE） and Montreal Cognitive Assessment （MoCA） were used to value cognitive level of patients, and Pittsburgh Sleep Quality Index （PSQI） was used to value sleep quality of patients. Cognitive level of patients with different sleep quality, or sleep quality in patients with different cognitive level were compared and explored their relationship. Results All patients were mild-to-moderate Parkinson disease. The number of patients with somnipathy was 37, and the incidence rate was 52.1%. UPDRS score of the patients with somnipathy （45. 7±15. 9） was higher than that of the patients with normal sleep quality （35.8± 13.8 ）, and the difference was statistically significant （P〈 0.05）. Among 71 patients with Parkinson disease cognitive dysfunction had appeared in 49 cases, and the total incidence rate was 69%. Furthermore, there were 28 patients with mild cognitive impairment, and the incidence rate was 39.4%. 21 cases with dementia had appeared, and the incidence rate was 29.6%. The average score of MMSE of the dementia group was （23.0±1.7）, meaned mild dementia. There were significant differences in sleep quality between the two groups （P ± 0.05）. Both of the MoCA score and MMSE score of the patients with somnipathy was higher than that of the patients with normal sleep quality [（20.5±5.3）vs. （23.7±4.2）],[（25.7±3.3）vs. （27.5±2.6）]. The Parkinson patients with dementia had poor sleep quality. According to PSQI score, the sleep quality of patients with Parkinson disease dementia was poorer than that of patients with normal cognitive function [（8.9 ± 4.5） vs. （5.2±3.3）, （P 〈 0.01）1. The Parkinson patients with somnipathy had the high incidence of cognitive impairment （P ± 0.05）. Conclusions The patients with mild-to-moderate Parkinson disease had the high incidence of somnipathy. The patients with severity degree of Parkinson disease were more suffered from somnipathy. The Parkinson patients with poor sleep quality had the poor cognitive function. The sleep quality of patients with Parkinson disease dementia was poorer than that of patients with normal cognitive function.