帕金森病患者疼痛与睡眠障碍的相关性

Correlation between pain and sleep disorders in Parkinson disease

目的 探讨伴疼痛的帕金森病（PD）患者的临床特征,并分析PD患者疼痛与睡眠障碍的相关性.方法 118例原发性PD患者分为伴疼痛组与不伴疼痛组,调查他们的一般特征,使用VAS评价患者的疼痛程度,使用UPDRSⅡ、UPDRSⅢ、H-Y分期、HAMD-17、HAMA量表、PDQ-8分别评价患者的运动症状、疾病严重程度、神经精神症状、生活质量.使用PDSS-2、ESS和PSG评价患者的睡眠情况.并对两组人群进行比较.结果 伴疼痛组病程长,UPDRS得分、H-Y分期、左旋多巴等效剂量、HAMD、HAMD、PDSS-2、PDQ-8得分均高于不伴疼痛组（P＜0.05）.HAMD和PDSS-2评分与是PD患者疼痛的独立危险因素.VAS评分与PDSS-2评分有相关性,伴疼痛的PD患者与不伴疼痛患者相比,PSG主要表现为入睡潜伏期延长,睡眠效率下降,N1百分比增多、觉醒次数增多.结论 PD患者中,抑郁、睡眠障碍是疼痛的影响因素;PD疼痛与睡眠障碍有相关性;伴疼痛的PD患者夜间睡眠更差.

Objective To discuss the clinical features of patients with Parkinson＇s disease（PD） and pain, and analyze the correlation of pain and sleep disorders in PD patients. Methods 118 cases of primary PD patients divided into groups with and without pain, investigate their general characteristics and evaluate the degree of pain using VAS, to evaluate the patient＇s motor symptoms, severity of disease, neuropsychiatric symptoms and quality of life by UPDRSII, UPDRSIII, H-Y staging, HAMD-17 and HAMD scale, PDQ-8 respectively. Using PDSS-2, ESS and PSG to evaluate the patient＇s sleep quality, and the two groups were compared. Results Group with pain had longer duration, UPDRS score, H -Y stage, equivalent close levodopa and scores of HAMD, PDSS-2, PDQ-8 were higher than the group without pain（p〈0.05）. HAMD and PDSS-2 scores were independent risk factors for PD patients with pain. VAS scores had correlation with PDSS-2 scores, PD patients with pain compared to without pain, PSG mainly for lengthening sleep latency, decreasing sleep efficiency, increasing the percentage of N1, increasing frequency of awakening. Conclusions Depression and sleep disorders were the factor of pain in PD patients; PD pain were associated with sleep disorders; Sleep at night was worse in PD patients with pain.