司来吉兰治疗早期帕金森病睡眠障碍的临床研究

Clinical Study of Selegiline for the Treatment of Sleep Disorder in Early Parkinson Disease

目的 研究司来吉兰治疗早期帕金森病（Parkinson disease ，PD）睡眠障碍的临床疗效和安全性。方法 将90例已用安坦、金刚烷胺、维生素E联合治疗的早期PD患者随机分为司来吉兰组和艾司唑仑组，前者在原用药物剂量不变的基础上添加司来吉兰片，5 mg／d ，后者添加艾司唑仑1 mg／d。疗程均为4周。90例患者在治疗前后分别进行匹兹堡睡眠质量指数（PSQI）问卷调查，分析两组患者在治疗前后的睡眠情况。同时在加药前后进行常规实验室指标检测，分析比较不良反应发生情况。结果 两组在治疗后PS Q I评分均明显好转，与治疗前相比较差异均有显著性（ P ＜0．01）。司来吉兰组和艾司唑仑组治疗后的 PSQI评分相比较差异无显著性（ P ＞0．05）。在PSQI中睡眠质量、日间功能、催眠药物三个因子的评分，两组在治疗后相比较差异有显著性（ P＜0．05）。司来吉兰组的总不良反应发生率为17．8％，艾司唑仑组为36．9％，两组间相比较差异有显著性（ P ＜0．05） ，其中治疗后嗜睡和直立性低血压不良反应发生率比较，司来吉兰组显著低于艾司唑仑组（ P ＜0．01）。结论 司来吉兰治疗早期帕金森病睡眠障碍安全、有效，并且在减少催眠药物的使用以及改善PD患者睡眠质量和日间功能方面明显优于艾司唑仑，值得推广应用。

Objective] To explore clinical efficacy and safety of selegiline for the treatment of sleep disor‐der in early Parkinson disease（PD） .[Methods] Totally 90 patients with early PD treated by trihexyphenidyl , amantadine and vitamin E were randomly divided into selegiline group and estazolam group .On the basis of the unchanged dose of original drugs ,the former was additionally given selegiline tablet 5mg/d ,while the latter was additionally given estazolam 1mg/d .The course was 4 weeks .All patients were surveyed by Pittsburg sleep quality index（PSQI） questionnaire .The sleep condition before and after treatment was analyzed .Mean‐while ,routine laboratory indexes were detected before and after the addition of the drugs .The incidence of ad‐verse reaction was analyzed and compared .[Results] After treatment ,the PSQI score was significantly im‐proved ,and there was significant difference between before and after treatment（ P〈0 .01） .There was no sig‐nificant difference in PSQI score after treatment between selegiline group and estazolam group（ P 〉 0 .05） . There were significant differences in the scores of 3 factors（sleep quality ,daytime function and hypnotic drug） in PSQI after treatment between two groups（ P 〈0 .05） .The incidence of adverse reaction in selegiline group and estazolam group was 17 .8% and 36 .9% respectively ,and there was significant difference between two groups（ P 〈0 .05） .The incidence of drowsiness and orthostatic hypotension in selegiline group was signifi‐cantly lower than that in estazolam group（ P〈0 .01） .[Conclusion]Selegiline for the treatment of sleep disor‐der in PD is safe and effective .Selegiline for reducing hypnotic drug and improving sleep quality of PD patients is obviously superior to estazolam ,so it is worthy of clinical promotion .