帕金森病患者睡眠障碍与抑郁焦虑和生活质量的相关性

Relationship between sleep disturbance with depression,anxiety and quality of life in patients with Parkinson s disease

目的探讨帕金森病(Parkinson’s disease,PD)患者的睡眠障碍与抑郁、焦虑和生活质量的相关性。方法连续入组2019年3~6月北京医院神经内科门诊就诊的100例PD患者,采用帕金森病睡眠量表第二版(PDSS-2)、贝克抑郁量表(BDI)、广泛性焦虑障碍量表(GAD-7)、8项帕金森病调查表(PDQ-8)分别调查PD患者睡眠质量、抑郁焦虑情绪及生活质量,分析PD患者睡眠障碍与抑郁、焦虑及生活质量的相关性。结果PD患者睡眠障碍发生率为46%(46/100),女性患者睡眠障碍发生率显著高于男性(χ^(2)=4.315,P=0.038)。PDSS-2评分与病程、Hoehn&Yahr分期、BDI总评分、GAD-7总评分、PDQ-8总评分均呈正相关性(分别r=0.423、0.488、0.687、0.494、0.619,均P<0.001),进一步多重线性回归分析也发现BDI评分(Beta=0.297,P=0.020)和Hoehn&Yahr分期(Beta=0.214,P=0.021)与PD睡眠障碍具有显著相关性。伴睡眠障碍的PD患者抑郁(z=-7.124,P=0.000)、焦虑(z=-4.735,P=0.000)状态的检出率显著高于无睡眠障碍的PD患者。PDSS-2评分与PDQ-8量表中在公共场所行走有困难、替自己穿衣有困难、感到抑郁、注意力难以集中、感到难以和别人沟通、觉得肌肉抽筋或痉挛,6个维度均有相关性(分别r=0.422、0.489、0.467、0.503、0.327、0.527,均P<0.01)。结论睡眠障碍是PD患者常见的非运动症状,伴睡眠障碍的PD患者更易发生抑郁、焦虑,睡眠障碍使PD患者整体生活质量全面降低。

Objective To investigate the correlation between sleep disturbance and depression,anxiety and quality of life in patients with Parkinson s disease(PD).Methods A total of 100 PD patients who were admitted to the eurological Department of Beijing Hospital from March to June 2019 were enrolled in this study.Parkinson s Disease Sleep Scale 2(PDSS-2),Beck s Depression Inventory(BDI),Generalized Anxiety Disorder Scale(GAD-7)and Parkinson s disease questionnaires 8(PDQ-8)were used to investigate sleep quality,depression,anxiety,and quality of life in PD patients.Then we analyzed the correlation between sleep disturbance and depression,anxiety and quality of life in the PD patients.Results The incidence of sleep disturbance in the PD patients was 46%(46/100),which was significantly higher in female patients than in male patients(χ^(2)=4.315,P=0.038).The higher the Hoehn-Yahr stage(H-Y stage),the higher the incidence of sleep disturbance in PD patients.PDSS-2 score was positively correlated with the course of disease,H-Y stage,total BDI score,total GAD-7 score and total PDQ-8 score(r=0.423,0.488,0.687,0.494,0.619,all P<0.001).Multiple linear regression analysis also found that BDI score(Beta=0.297,P=0.020)and H-Y stage(Beta=0.214,P=0.021)were significantly correlated with PD sleep disturbance.The detection rates of depression(z=-7.124,P=0.000)and anxiety(z=-4.735,P=0.000)in PD patients with sleep disturbance were significantly higher than those in PD patients without sleep disturbance.PDSS-2 score was correlated with difficulties in walking in public places,difficulty in dressing oneself,depression,difficulty in concentrating,difficulty in communicating with others,and muscle cramps or spasms in the PDQ-8 scale(r=0.422,0.489,0.467,0.503,0.327,0.527,respectively,P<0.01).Conclusions Sleep disturbance is a common non-motor symptom in PD patients.PD patients with sleep disturbance are more prone to depression and anxiety,and sleep disturbance reduces the overall quality of life of PD patients.