Objective To explore the relationship between the characteristics of polysomnography and cognitive dysfunction in patients with Parkinson’s disease.Methods A total of 207 patients diagnosed as Parkinson’s disease in the Department of Neurology of our hospital from January 2021 to January 2022 were selected.All patients received Parkinson’s Sleep Scale（PDSS） to assess their sleep status, and the included patients were divided into two groups according to their final scores: the sleep disorder free group（n=126） and the sleep disorder group（n=81）.Clinical data of all patients were collected and monitored by polysomnography.The difference of baseline data, EEG data, polysomnography parameters and sleep-related scores between the two groups were compared to observe the cognitive function of the two groups.Scores related to anxiety and depression and scores of various dimensions of MoCA.Results Results The age and course of disease in sleep disorder group increased significantly than those in no sleep disorder group（all P＜0.05）.The amplitude, frequency, index and generalization ratio of EEG parameters in 2 groups were all P＜0.05.The sleep efficiency of patients without sleep disorder group was significantly higher than that of sleep disorder group, the proportion of NREM2 sleep in patients without sleep disorder group decreased significantly than that of sleep disorder group, and the proportion of NREM3 sleep in patients without sleep disorder group increased significantly than that of sleep disorder group（all P＜0.05）.The proportion of rapid eye movement sleep in barrier-free sleep group increased significantly than that in sleep disorder group（P＜0.05）.The comparison of UPDRS score, H-Y stage and PDSS scores in 2 groups were all P＜0.05.The cognitive function scores including MMSE and MoCA scale scores in the sleep disorder group decreased significantly than those in the non-sleep disorder group, and the anxiety and depression scores in the sleep disorder group increased significantly than those in the non-sleep disorder group（all P＜0.05）.Conclusion Analysis was used to show negative associations between age（r=-0.482,P=0.001）,H-Y stage（r=-0.414,P=0.005）,HAMA score（r=-0.591,P＜0.001）,HAMD score（r=-0.574,P＜0.001）,and MoCA scale score（r=-0.583,P＜0.001） with sleep disorders Conclusion There is a certain correlation between cognitive dysfunction and sleep structure disorder in PD patients.Sleep structure disorder may lead to increased cognitive impairment.

目的 探讨帕金森病(Parkinson disease,PD)患者睡眠障碍与认知功能障碍的关系.方法 收集2018年9月至2020年1月本院住院PD患者的临床资料进行回顾性分析,根据PD睡眠量表评估结果将患者分成睡眠障碍组与无睡眠障碍组,依靠帕金森病统一评分量表(MDS-UPDRS)评分和Hoehn-Yahr分期评估病情进展,分别通过简易精神状态检查量表、蒙特利尔认知评估量表、Stroop色词测验、言语流畅测验、数字广度测验评估认知功能,汉密尔顿抑郁量表、汉密尔顿焦虑量表评估情绪症状.结果 共纳入研究对象111例,其中帕金森病睡眠障碍组86例,帕金森病无睡眠障碍组25例.与帕金森病无睡眠障碍组相比,帕金森病睡眠障碍组UPDRS Ⅱ评分更高(15.0 vs.10.0,P=0.034),PD 睡眠量表总分及亚项 1(4.5 vs.7.0,P＜0.001)、亚项3(3.0 vs.7.0,P＜0.001)、亚项 14(4.0 vs.9.0,P＜0.001)、亚项15(2.50 vs.8.0,P＜0.001)评分低;在非运动量表评估中,帕金森病睡眠障碍组较帕金森病无睡眠障碍组的简易精神状态检查量表(25.24±4.22 vs.22.23±5.47,P=0.013)、蒙特利尔认知评估量表(19.20±5.53 vs.15.73±5.57,P=0.007)评分降低,Stroop色词测验卡片A用时延长(4.60 vs.3.50,P＜0.001),汉密尔顿焦虑量表(21.50 vs.15.00,P=0.002)和汉密尔顿抑郁量表(19.0 vs.13.0,P=0.002)评分增加,认知亚项包括总视空间和执行功能(2.00±1.41 vs.2.85±1.74,P=0.017)、注意力(4.14±1.72 vs.6.80±1.80,P＜0.001)、定向力(4.61±1.47 vs.5.50±0.98,P＜0.001)等分项得分较差.帕金森病睡眠障碍组出现认知功能障碍比例显著升高(76.7％vs.36.0％,P＜0.001).回归分析提示PD睡眠量表评分下降是认知功能受损的危险因素(OR=0.235,P＜0.05).结论 PD患者伴有睡眠障碍者易出现认知功能障碍.

目的 探讨帕金森病(PD)患者血清sICAM-1与α-Synuclein水平与认知功能损害的关联性.方法 选取广东三九脑科医院2018年1月至2020年12月收治的169例PD患者,并根据Hoehn-Yahr分级分为2组,其中1～2级患者纳入轻症组(93例),3～5级患者纳入重症组(76例),采用酶联免疫吸附法测定血清中sIC AM-l、α-Synuclein水平,比较轻症组和重症组患者血清sICAM-1与α-Synuclein水平,分析不同认知功能障碍的PD患者血清sICAM-1与α-Synuclein水平差异性,分析血清sICAM-1、α-synuclein水平与PD患者认知功能的相关性,分析PD患者认知障碍的危险因素.结果 重症组患者血清sICAM-1与α-Synuclein水平明显高于轻症组(P＜0.05).重症组中重度认知功能障碍组血清sICAM-1与α-Synuclein水平均高于轻中度认知功能障碍组和认知功能正常组(P＜0.05),轻中度认知功能障碍组血清sICAM-1与α-Synuclein水平均高于认知功能正常组(P＜0.05).Pearson相关性分析,sICAM-1、α-Synuclein水平与MoCA 评分呈负相关(r=0.547、0.529,P＜0.05).Logistic 分析结果显示,血清 sICAM-1、α-Synuclein 均是PD患者认知障碍的的危险因素(P＜0.05).结论 血清sICAM-1、α-Synuclein水平与PD病患者的认知功能密切相关,可为临床评估患者的认知功能障碍提供一定的参考依据.

目的:探讨在帕金森病患者治疗中采用神经生长因子联合盐酸多奈哌齐胶囊对脑神经递质及CRP、IL-6水平的影响.方法:选取2017年7月～2021年1月接受治疗的110例帕金森病患者作为研究对象,根据随机数字表法将患者分为观察组(n=55)与对照组(n=55),对照组使用盐酸多奈哌齐胶囊治疗,观察组在对照组基础上联合神经生长因子治疗,对两组临床疗效、氧化应激指标、炎性因子及脑神经递质进行比较.结果:观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);两组治疗后血清超氧化物歧化酶(SOD)较治疗前明显提高,差异有统计学意义(P<0.05),且观察组高于对照组,差异有统计学意义(P<0.05),丙二醛(MDA)较治疗前明显下降,差异有统计学意义(P<0.05),且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后C-反应蛋白(CRP)、白介素-6(IL-6)较治疗前明显下降,差异有统计学意义(P<0.05),观察组较对照组下降更明显,差异有统计学意义(P<0.05);两组治疗后去甲肾上腺素(NE)、多巴胺(DA)、5羟色胺(5-HT)明显高于治疗前,差异有统计学意义(P<0.05),观察组明显高于对照组,差异有统计学意义(P<0.05).结论:将神经生长因子联合盐酸多奈哌齐胶囊应用于帕金森病患者治疗中可降低CRP、IL-6水平,促进脑神经递质的改善.