帕金森病合并睡眠障碍患者发生认知功能障碍的相关危险因素分析

Related Risk Factors of Cognitive Dysfunction in Patients with Parkinson’s Disease Combined with Sleep Disorders

目的分析帕金森病(PD)合并睡眠障碍患者发生认知功能障碍的相关危险因素。方法收集2016年3月—2018年4月收治的126例PD患者的临床资料进行回顾性分析,根据是否发生睡眠障碍分为睡眠障碍组与非睡眠障碍组,每组63例。采用帕金森病睡眠量表(PDSS)、Epworth嗜睡量表(ESS)、匹兹堡睡眠质量指数量表(PSQI)和蒙特利尔认知评估量表(MoCA)分别评估PD患者的睡眠状况和认知功能,记录PD合并睡眠障碍患者认知功能障碍发生情况,并采用多因素Logistic回归分析影响PD合并睡眠障碍患者发生认知功能障碍的相关危险因素。结果睡眠障碍组的ESS、PSQI评分明显高于非睡眠障碍组,PDSS、MoCA评分明显低于非睡眠障碍组(P<0.01)。63例PD合并睡眠障碍患者中出现认知功能障碍患者44例,占比69.84%。年龄≥65岁、PD病程≥2年、PDSS评分<90分、ESS评分≥7分、PSQI评分≥14分、MoCA评分<26分是影响PD合并睡眠障碍患者发生认知功能障碍的独立危险因素(P<0.05)。结论PD合并睡眠障碍患者出现认知功能障碍的概率较大,高龄、病程长、PDSS、ESS、PSQI及MoCA评分是影响患者发生认知功能障碍的独立危险因素。

Objective To analyze related risk factors of cognitive dysfunction in patients with Parkinson's disease(PD)combined with sleep disorders.Methods Clinical data of 126 PD patients admitted during March 2016 and April 2018 was retrospectively analyzed,and the patients were divided into sleep disorder group and non-sleep disorder group(n=63 in each group)according to whether or not having sleep disorders.Conditions of sleep status and cognitive dysfunction of PD patients were assessed by Parkinson disease sleep scale(PDSS),Epworth sleepiness scale(ESS),Pittsburgh sleep quality index(PSQI)and Montreal cognitive assessment(MoCA)scale respectively.Occurrence conditions of cognitive dysfunction in PD patients with sleep disorder were recorded,and multivariate Logistic regression analysis was used to analyze risk factors of cognitive dysfunction in patients with PD combined with sleep disorders.Results In sleep disorder group,ESS and PSQI scores were significantly higher,while PDSS and MoCA scores were significantly lower than those in non-sleep disorder group(P<0.01).Among 63 PD patients with sleep disorder,44 patients(69.84%)had cognitive dysfunction.Age equal or more than 65 years old,course of disease equal or more than 2 years,PDSS score less than 90,ESS score equal or more than 7,PSQI score equal or more than 14 and MoCA score less than 26 were independent risk factors of cognitive dysfunction in patients with PD combined with sleep disorder(P<0.05).Conclusion Patients with PD combined with sleep disorder are more likely to have cognitive dysfunction,and eldly,long course of disease,PDSS,ESS,PSQI and MoCA scores are independent risk factors affecting pathogenesy of cognitive dysfunction.