發(fā)布時(shí)間：2018-04-08 14:38

  本文選題：帕金森病　切入點(diǎn)：日間過(guò)度思睡　出處：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:日間過(guò)度思睡(excessive daytime sleepiness,EDS)是帕金森病患者常見(jiàn)非運(yùn)動(dòng)癥狀之一。本研究的目的是評(píng)估帕金森病患者日間過(guò)度思睡情況,并分析其與年齡、性別、運(yùn)動(dòng)系統(tǒng)癥狀、服藥情況、夜間睡眠情況及情感狀況等因素的相關(guān)性。方法:連續(xù)收集大連醫(yī)科大學(xué)附屬第二醫(yī)院2015年01月01日-2016年12月31日神經(jīng)內(nèi)科住院及門診就診符合入組標(biāo)準(zhǔn)的帕金森病患者112例組成帕金森病組,120例在年齡、性別上相匹配的健康人組成為對(duì)照組。采用愛(ài)潑沃斯思睡量表(Epworth sleepiness scale,ESS)評(píng)定日間過(guò)度思睡(EDS)情況,比較帕金森病組與健康對(duì)照組的EDS發(fā)生情況。根據(jù)ESS評(píng)分將帕金森患者分為EDS組(ESS≥10分)和非EDS組(ESS10分),并對(duì)兩組間在年齡、性別、病程、疾病嚴(yán)重程度、情感狀態(tài)、夜間睡眠情況及服用藥物史等相關(guān)因素進(jìn)行分析。從中選取具有統(tǒng)計(jì)學(xué)意義(P0.05)的因素進(jìn)行Logistic回歸分析,從而找出EDS發(fā)生的獨(dú)立危險(xiǎn)因素。結(jié)果:一、一般資料本研究包括112例PD患者,男性62例(55.36%),女性50例(44.64%),平均年齡在68.82±8.82歲。對(duì)照組男性60例(50.00%),女性60例(50.00%),平均年齡在66.70±10.33。PD組患者中有44例(39.28%)ESS≥10分,健康對(duì)照組有16例(13.33%)ESS≥10分,兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。二、EDS相關(guān)因素分析1、EDS組男性(59.09%)比非EDS組男性(52.94%)比例大,在病程上EDS組(5.06±2.65年)要比非EDS組病程長(zhǎng)(4.71±3.53年),但兩組間比較沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)。2、EDS組與非EDS組比較,在年齡、HAMD評(píng)分、Hoehn-Yahr評(píng)分、UPDRS-Ⅲ評(píng)分、PSQI評(píng)分、是否服用多巴胺受體激動(dòng)劑及左旋多巴藥物劑量比較差異有統(tǒng)計(jì)學(xué)差異(P0.05)。3.將上述分析中具有統(tǒng)計(jì)學(xué)意義的因素進(jìn)行多因素回歸分析結(jié)果顯示,HAMD評(píng)分(OR=1.221,95%CI 1.006-1.483),左旋多巴等效劑量(OR=1.009,95%CI1.003-1.015)及是否服用多巴胺受體激動(dòng)劑(OR=5.475,95%CI 1.094-27.398)以上3個(gè)變量有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:一、帕金森患者日間過(guò)度思睡發(fā)生率為39.28%,明顯高于健康對(duì)照組。二、通過(guò)本次研究,發(fā)現(xiàn)患者的抑郁情況、是否應(yīng)用多巴胺受體激動(dòng)劑及多巴胺藥物劑量可能是日間過(guò)度思睡發(fā)生的獨(dú)立危險(xiǎn)因素。三、臨床工作中,對(duì)藥物選擇要謹(jǐn)慎,特別是左旋多巴藥物劑量應(yīng)用較大及聯(lián)合多巴胺受體激動(dòng)劑時(shí),觀察日間過(guò)度思睡情況,防止出現(xiàn)危險(xiǎn)。
[Abstract]:Objective: excessive daytime sleepiness (EDS) is one of the common non-motor symptoms in patients with Parkinson's disease.The purpose of this study was to evaluate the daytime overthinking of sleep in patients with Parkinson's disease and to analyze its correlation with age, sex, motor system symptoms, medication, night sleep and emotional status.Methods: one hundred and twelve patients with Parkinson's disease in the second affiliated Hospital of Dalian Medical University from January 01, 2015 to December 31, 2016, who were admitted to the Department of Neurology and outpatient Service, were collected. 120 patients with Parkinson's disease were enrolled in this study.Sex matched healthy persons were used as control group.Epworth sleepiness scale (ESSs) was used to evaluate the incidence of EDS in patients with Parkinson's disease (PD) and healthy controls.According to ESS score, Parkinson's patients were divided into EDS group (ESS 鈮，

本文編號(hào)：1722049