快速眼动睡眠期行为障碍(RBD)的帕金森病临床特征分析

目的:探究合并不同发作形式的快速眼动睡眠期行为障碍(RBD)与帕金森病的临床特点及自主神经功能障碍变化。方法:采用快速眼动期睡眠行为障碍筛查量表及帕金森综合评分量表(Unified Parkinson's disease rating scale),对20例合并简单型(RBD)的帕金森病患者(RBD-简单组)与20例合并复杂型(RBD)的帕金森病患者(RBD-复杂组)进行研究。结果:两组帕金森病患者的一般情况、左旋多巴药物日剂量、疾病病程等无统计学差异(P>0.05)。合并复杂型(RBD)的帕金森病患者运动部分评分高于合并简单型(RBD)的帕金森病患者(P<0.05)。两组患者之间在非震颤、强直、运动减少症状均存在统计学差异(P<0.05),(RBD)复杂组评分均高于(RBD)简单组。多因素logistics回归显示,复杂型(RBD)的存在与UPDRS-Ш部分评分相关,而与年龄、病程、教育年限、左旋多巴药物日剂量等无显著相关,与运动减少症状最为相关,与震颤、非震颤、强直症状无相关性。两组患者运动障碍类型与(RBD)发作形式无明显相关性(P=0.108)。结论:合并复杂型(RBD)的帕金森病患者运动症状更重,并且累及运动障碍的诸多方面。帕金森病患者存在复杂型(RBD)症状主要与UPDRS-Ш评分相关,其中与运动减少方面显著相关。

Clinical Features of Parkinson's Disease with Behavioral Disorder During Rapid Eye Movement Sleep

Objective:To explore the clinical features and autonomic nerve dysfunction of REM sleep behavior disorder and Parkinson's disease combined with different seizure forms.Methods:20 patients with Parkinson's disease combined with simple RBD(RBD-simple group)and 20 patients with complex RBD-complex group(RBD-complex group)were compared and studied by using the RAPID eye movement sleep behavior disorder screening scale and the Unified Parkinson's Disease Rating Scale.Results:There were no significant differences in the general condition,daily dose of levodopa drug,and the course of disease between the two groups(P>0.05).The motor scores of Parkinson's disease patients with complex RBD were higher than those of Parkinson's disease patients with simple RBD(P<0.05).There were statistical differences in non-tremor,rigidity,and reduced motor symptoms between the two groups(P<0.05).The scores of the RBD complex group were higher than those of the RBD simple group.Multivariate logistic regression showed that the existence of complex RBD was related to partial scores of UPDRS-Ш,but not significantly related to age,course of disease,years of education,daily dose of levodopa drug,etc.,and was most related to reduced symptoms of exercise,and was not related to the symptoms of tremor,non tremor and rigidity.There was no significant correlation between the type of movement disorder and the form of RBD in the two groups(P=0.108).Conclusion:Pd patients with complex RBD have more severe motor symptoms and involve many aspects of motor disorders,which is associated with UPDRS-Шscore,and is most related to reduced symptoms of exercise.