慢性疼痛对帕金森患者睡眠质量影响的临床研究

Clinical research on influence of chronic pain on sleep quality in patients with Parkinson′s disease

目的探讨慢性疼痛对帕金森病(PD)患者睡眠质量的影响。方法选取该院神经内科2009年3月至2013年3月间收治的PD患者232例,根据有无伴有慢性疼痛发生分为有疼痛的PD患者106例(PPD组)和无疼痛的PD患者126例(NPPD组),选择同期健康体检者140例作为对照组。采用匹兹堡睡眠质量指数量表(PSQI)和疲劳量表(FS-14)判断患者是否存在睡眠障碍,比较3组对象的睡眠质量和疲劳情况差异。同时分析影响睡眠障碍的相关因素。结果 3组对象的PSQI和FS-14得分两两比较,均差异有统计学意义(P<0.05),其中在睡眠潜伏期、主观睡眠质量、睡眠持续性、习惯性睡眠效率和睡眠紊乱方面差异有统计学意义(P<0.05)。患者的睡眠障碍影响因素是Hoehn-Yahr分期(r=-0.79,P<0.05)、多巴胺服用剂量(r=-0.38,P=0.04)、疼痛有无(r=-0.57,P<0.05)及抑郁程度(r=-0.63,P<0.05)有关。结论伴随疼痛的PD患者更易发生睡眠障碍,其睡眠质量较无伴随疼痛者差,临床应做好早期干预治疗。

Objective To investigate the influence of chronic pain on the sleep quality in the patients with Parkinson′s disease （PD） .Methods 232 cases of PD in the neurology department of this hospital from March 2009 to March 2013 were selected and di‐vided into the pain PD group （PPD group ,106 cases） and the non‐pain PD group （NPPD group ,126 cases） according to whether accompanying chronic pain .Contemporaneous 140 individual of healthy physical examination were selected as the control group .The Pittsburgh Sleep Quality Index Scale （PSQI） and the fatigue scale （FS‐14） were used to judge whether sleep disorders existing . Then the differences in the sleep quality and fatigue condition were compared among three groups .The related factors of sleeping disorders were also analyzed .Results The scores of PSQI and FS‐4 had statistically significant differences among 3 groups （P〈0 .05） ,in which the differences in the aspects of sleep latency ,subjective sleep quality ,sleep continuity ,habitual sleep efficiency and sleep disorders also were statistically significant （P〈0 .05） .The influencing factors of sleeping disorders were the Hoehn‐Yahr stage （r = -0 .79 ,P〈0 .05） ,dopamine dose （r = -0 .38 ,P=0 .04） ,presence of pain （r = -0 .57 ,P〈0 .05） and severity of de‐pression （r = -0 .63 ,P〈0 .05） .Conclusion The PD patients accompanying pain are more susceptible to develop sleep disorders , the sleep quality accompanying pain is worse than that without accompanying pain .Therefore the early intervention should be well conducted in clinic .