帕金森病伴RBD患者睡眠结构与认知功能及自主神经功能症状的相关性

Correlation of sleep structure with cognitive function and autonomic nervous function in patients with Parkinson's and RBD

摘要:

目的 探究帕金森病伴快速眼动期睡眠行为障碍（RBD）患者睡眠结构与认知功能及自主神经功能症状的相关性。方法 回顾性分析2017年6月—2019年6月在张家口市第一医院就诊的160例帕金森病患者，根据其是否伴有RBD分为研究组（帕金森病伴RBD）80例与对照组（单纯帕金森病）80例。检测并比较两组患者的睡眠结构与认知功能及自主神经功能症状，并采用Pearson相关系数分析研究组患者睡眠结构与自主神经功能症状评分的相关性。结果 研究组的NREM1+2期睡眠比例、睡眠潜伏期、REM睡眠潜伏期、消化系统、泌尿系统、心血管系统的症状评分大于对照组（P <0.05）；NREM3+4期睡眠比例、REM期睡眠比例、REM睡眠潜伏期、REM睡眠周期、TST、SE、MMSE、MoCA评分小于对照组（P <0.05）。相关性分析结果显示，NREM1+2期睡眠比例与体温调节系统评分呈负相关（r =-0.341，P <0.05）；NREM3+4期睡眠比例与泌尿系统评分呈负相关（r =-0.344，P <0.05）；睡眠潜伏期与MMSE、消化系统、泌尿系统、心血管系统评分呈正相关（r =0.569、0.606、0.671和0.403，均P <0.05）；REM睡眠潜伏期与消化系统、泌尿系统、心血管系统评分呈正相关（r =0.630、0.600和0.361，均P <0.05）；REM睡眠周期与消化系统、泌尿系统、心血管系统评分呈正相关（r =0.571、0.599和0.357，均P <0.05）；TST与消化系统、泌尿系统、心血管系统评分呈正相关（r =0.678、0.631和0.369，均P <0.05）；SE与消化系统、泌尿系统、心血管系统评分呈正相关（r =0.554、0.559和0.406，均P <0.05）。结论 睡眠结构与认知功能及自主神经功能（消化系统、泌尿系统、心血管系统）存在一定相关性，可推断帕金森病伴RBD患者睡眠结构紊乱可加重认知功能障碍和自主神经功能症状。

Abstract:

Objective To explore the relationship between sleep structure and cognitive function and autonomic nervous function symptoms in patients with Parkinson's disease (Parkinson's disease, PD) with REM sleep behavior disorder (REM sleep disorder, RBD) in patients.Methods A retrospective method selected 160 PD patients in our hospital from June 2017 to June 2019, and divided them into a study group (PD with RBD) and control group (simple PD patients) according to whether they were accompanied by RBD, with 80 patients in each group. people. The sleep structure, cognitive function, and autonomic nervous function symptoms of the two groups of patients were detected and compared, and the Pearson correlation coefficient was used to analyze the relationship between sleep structure and autonomic nervous function symptoms in the study group.Results The comparison results showed that the NREM1+2 stage sleep ratio, sleep latency, REM sleep latency, digestive system, urinary system, and cardiovascular system scores in the study group were greater than those of the control group, but NREM3+4 stage sleep ratio, REM sleep ratio, REM sleep latency, REM sleep cycle, TST, SE, MMSE, and MoCA scores were lower than those of the control group, and the difference was statistically significant (P < 0.05). The results of correlation analysis showed that the proportion of NREM1+2 sleep was negatively correlated with the thermoregulatory system (r = -0.341, P < 0.05); the proportion of NREM3+4 sleep was negatively correlated with the urinary system (r = -0.344, P < 0.05); sleep latency is positively correlated with MMSE, digestive system, urinary system, and cardiovascular system (r = 0.569, 0.606, 0.671, 0.403, all P < 0.05); REM sleep latency is positively correlated with digestive system, urinary system, and cardiovascular system (r = 0.630, 0.600, 0.361, all P < 0.05); REM sleep cycle is positively correlated with digestive system, urinary system, and cardiovascular system (r = 0.571, 0.599, 0.357, all P < 0.05); TST was positively correlated with digestive system, urinary system, and the cardiovascular system (r = 0.678, 0.631, 0.369, all P < 0.05); SE was positively correlated with the digestive system, urinary system, and cardiovascular system (r = 0.554, 0.559, 0.406, all P < 0.05).Conclusions Sleep structure shows a certain correlation with cognitive function and autonomic nervous function (digestive system, urinary system, cardiovascular system). It can be inferred that sleep structure disorder in PD patients with RBD can aggravate cognitive dysfunction and autonomic nervous function symptoms.