张柳娟　　缪琴华　　夏清

[摘要] 目的 調查帕金森病合并睡眠障碍患者精神行为症状、认知障碍及生活质量情况，探讨提升帕金森病合并睡眠障碍患者生活质量对策。 方法 选取2017年7月至2019年12月我院和浙江医院收治的帕金森病合并睡眠障碍患者90例，采用患者基础资料调查表、简明精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）及帕金森病生活质量调查量表（PDQ39）对患者综合情况进行调查，分析数据特点及相关性。 结果 （1）帕金森病合并睡眠障碍患者PDQ39评分为（90.21±6.84）分，MoCA得分为（19.35±2.26）分，MMSE评分为（18.27±2.87）分;（2）不同性别、学历、职业状况、帕金森病分期、睡眠障碍指数、睡眠障碍病程、HAMA、HAMD的帕金森并合并睡眠障碍患者MMSE得分、MoCA评分及PDQ39评分比较，差异有统计学意义（P<0.05）;（3）帕金森病合并睡眠障碍患者PDQ39评分与MMSE得分、MoCA评分呈负相关（r=-0.648、-0.594，P<0.01）。 结论 帕金森病合并睡眠障碍患者认知水平及生活质量处于较低水平、精神行为症状处于较高水平，采取措施提升患者睡眠质量、改善精神行为症状、提高认知水平可提升患者生活质量。

[关键词] 帕金森病;睡眠障碍;简明精神状态检查量表;蒙特利尔认知评估量表

[中图分类号] R742.5          [文献标识码] B          [文章编号] 1673-9701（2021）15-0151-05

Investigation on psychobehavioral symptoms，cognitive disorder and quality of life in patients with Parkinson′s disease combined with sleep disorders

ZHANG Liujuan   MIAO Qinhua   XIA Qing

The Fifth Cadre Office， Zhejiang Provincial People′s Hospital， Affiliated People′s Hospital of Hangzhou Medical College， Hangzhou   310024， China

[Abstract] Objective To investigate on psychobehavioral symptoms，cognitive disorder and quality of life in patients with Parkinson′s disease combined with sleep disorders，and to explore the strategies to improve the quality of life in patients with Parkinson′s disease combined with sleep disorders. Methods Ninety patients with Parkinson′s disease combined with sleep disorders treated in our hospital and Zhejiang Hospital from July 2017 to December 2019 were selected. Basic Patient Information Questionnaire， Mini-Mental State Examination（MMSE）， Montreal Cognitive Assessment （MoCA）， Parkinson′s Disease Questionnaire （PDQ39） were used to investigate the comprehensive situation of patients， and to analyze the data characteristics and correlation. Results （1）In patients with Parkinson′s disease combined with sleep disorders， PDQ39 score was（90.21±6.84）points， MoCA score was （19.35±2.26）points， and MMSE score was （18.27±2.87）points. （2）There were statistically significant differences in PDQ39 score， MMSE score，and MoCA score among the patients with Parkinson′s disease combined with sleep disorders with different sex， education background， occupational status， Parkinson′s disease stage， sleep disorder index， course of sleep disorder， HAMA and HAMD（P<0.05）. （3）PDQ39 score was negatively correlated with MMSE score and MOCA score in patients with Parkinson′s disease combined with sleep disorders（r=-0.648， -0.594， P<0.01）. Conclusion The cognitive level and quality of life of patients with Parkinson′s disease combined with sleep disorders are at a low level， and the psychobehavioral symptoms are at a high level. Taking measures to improve the sleep quality， the psychobehavioral symptoms， and the cognitive level can improve the quality of life of patients.

[Key words] Parkinson′s disease; Sleep disorders; Mini-mental state examination; Montreal cognitive assessment

帕金森病（Parkinson's disease，PD）是老年人群的常见神经系统疾病，其病理表现为中脑黑质多巴胺神经元变形、坏死;主要临床表现为动作迟缓、静止震颤[1]。帕金森病病情进展至一定程度可并发多种并发症，包括睡眠障碍、精神障碍，如抑郁、认知障碍、异动症等，加上疾病本身的临床症状，可能严重影响患者的生活、工作，严重者甚至生活无法自理，对患者及其家庭成员的生活质量造成较大的影响[2]。睡眠障碍（Sleep disorders）是帕金森病患者最为常见的并发症，可发病在帕金森病的任何阶段。帕金森病合并睡眠障碍随着病程发展，患者出现日间瞌睡、异态睡眠、失眠等临床症状，随着患者的疾病进展其严重程度递增，表现为异态睡眠、日间多瞌睡、失眠等，严重影响了患者的休息质量，对其神经健康造成持续的危害，影响患者的身心健康[3]。……