帕金森病患者睡眠障碍与褪黑素水平的相关性-现代医学

帕金森病患者睡眠障碍与褪黑素水平的相关性

单位：上海市奉贤区中心医院中西医结合科, 上海 201400

分类号：R742.5

出版年·卷·期（页码）：2019·47·第四期（431-434）

摘要：

目的：探讨帕金森病（PD）患者自我报告的睡眠质量与褪黑素（MLT）水平的相关性。方法：选取我院神经内科住院治疗的PD患者117例，根据帕金森病睡眠量表（PDSS）评分结果分为睡眠障碍组71例和非睡眠障碍组46例，采用帕金森病评分量表（UPDRS）和Hoehn-Yahr分期评估两组的病情；检测两组6个时间点血清MLT水平；分析PD患者睡眠障碍的影响因素。结果：（1）睡眠障碍组UPDRS各分量表及总分均高于非睡眠障碍组（P<0.01）；在Hoehn-Yahr分期中，睡眠障碍组Ⅲ期患者所占比例高于非睡眠障碍组，Ⅰ期患者所占比例低于非睡眠障碍组（P<0.05）；（2）睡眠障碍组6：00、10：00、14：00、18：00时血清MTL水平均高于非睡眠障碍组（P<0.01）；（3）Logistic回归分析显示，UPDRS-Ⅲ评分、UPDRS总分及血清MTL水平为PD患者发生睡眠障碍的危险因素（P<0.05）。结论：存在睡眠障碍的PD患者血清MLT水平升高，其可能是导致PD患者睡眠障碍的因素之一。

Objective:To explore the relationship between sleep disturbance and changes of melatonin level in patients with Parkinson's disease(PD). Methods:One hundred and seventeen patients with PD admitted to the Department of Neurology in our hospital were selected. All subjects were divided into two groups, i.e., sleep disturbance group(n=71) and non-sleep disturbance group(n=46),according to the score of Parkinson's disease sleep scale sleep(PDSS), and the illness state and levels of melatonin(MLT) on 6 time points were assessed and compared between the two groups by united Parkinson's disease rating scale(UPDRS)and Hoehn-Yahr staging and enzyme linked immunosorbent assay(ELISA). Multivariate Logistic Regression was used to analyze the factors influencing sleep disturbance in patients with PD. Results:(1)Each subscale score and total score in UPDRS were higher in sleep disturbance group than those in non-sleep disturbance group(P<0.01), and in Hoehn-Yahr staging, the ratio of Ⅲ staging was higher and the ratio of Ⅰ staging was lower in sleep disturbance group than those in non-sleep disturbance group respectively(P<0.05). (2)The serum MTL levels at 6:00, 10:00, 14:00, 18:00 were higher in sleep disturbance group than those in non-sleep disturbance group(P<0.01). (3)Multivariate Logistic Regression showed that UPDRS-Ⅲ score, UPDRS total score and serum MTL levels were risk factors for sleep disturbance in patients with PD(P<0.05). Conclusion:The serum MTL levels are higher in patients with PD, and MTL may be one of the factors leading to sleep disorders in PD patients.

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