帕金森病患者的疲劳发生特点以及睡眠行为干预对疲劳的影响

摘要

目的 探讨帕金森病(Parkinson's disease,PD)患者的疲劳发生特点及影响因素,探讨睡眠行为干预对疲劳的影响.方法 便利抽样选择2011年7月至2015年12月期间PD患者55例为研究对象,采用统一PD评分量表(unified parkinson's disease rating scale,UPDRS)第3部分、修订的Hoehn-Yahr量表、非运动症状量表(non-motor symptoms scale,NMSS)和疲劳严重度量表(fatigue severity scale,FSS)评价其运动症状、疾病严重程度、非运动症状以及疲劳程度.应用Logistic多元回归分析疲劳的独立危险因素.在此基础上,对各研究对象行基线 FFS评分和PD睡眠量表(Parkinson'S disease sleep scale, PDSS)评分后,给予睡眠行为干预,3个月后再次行FFS评分和PDSS评分.结果 本组患者FSS评分为(3.8 ± 1.8)分,25例(45.5%)PD患者存在疲劳.Logistic多元回归分析显示,睡眠评分、情绪与认知评分是影响疲劳的独立危险因素.干预后睡眠行为FFS评分、疲劳发生率均显著降低,而PDSS评分显著升高(均 P<0.05).结论 疲劳是PD患者常见非运动症状,睡眠障碍、情绪与认知障碍是其独立的危险因素,而睡眠行为干预能够有效地降低疲劳水平,值得在临床中进一步推广应用.%Objective To observe the fatigue characteristics and influencing factors and to explore the effect of sleep behavior intervention on fatigue in patients with Parkinson's disease(PD).Methods By con-venience sampling,55 PD patients were selected and investigated by using unified Parkinson's disease rat-ing scale(UPDRS)part III,revised Hoehn-Yahr scale,non-motor symptom scale(NMSS)and fatigue se-verity scale(FSS)to evaluate motor symptoms and disease severity,non-motor symptom and fatigue level. Logistic regression was used to analyze the independent risk factors of fatigue.On the basis of the study,af-ter the evaluation of the baseline FFS and Parkinson's disease sleep scale(PDSS)conducted,the partici-pants were given sleep behavior intervention.After 3 months,FFS and PDSS were evaluated again.Results FSS score was(3.8 ± 1.8),and 25 patients(45.5%)showed fatigue.Logistic regression analysis showed that sleep disorder,emotional and cognitive disorder were the independent risk factors for fatigue.The FFS score and the incidence of fatigue significantly decreased after sleep behavior intervention,while the PDSS score significantly increased.Conclusion Fatigue is a common non-motor symptom of PD patients.Sleep disor-der,mood and cognitive disorder are independent risk factors for fatigue.Sleep behavior intervention can effectivelyreduce the fatigue level,which is worthy of further application in clinical practice.