摘要： 目的 探讨快速眼动睡眠期行为障碍（RBD）发病至出现帕金森病运动症状的时间间隔与帕金森病临床特征的相关性。方法 纳入2019年9月至2021年12月天津市环湖医院收治的123例帕金森病患者，分为帕金森病伴很可能的RBD组（伴RBD组，41例）和帕金森病不伴很可能的RBD组（不伴RBD组，82例），采用Hoehn-Yahr分期进行帕金森病疾病分级，统一帕金森病评价量表第三部分（UPDRSⅢ）评价运动症状，简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（MoCA）评价认知功能，汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评价焦虑和抑郁症状严重程度，帕金森病睡眠量表（PDSS）评价睡眠障碍，非运动症状量表（NMSS）评价总体非运动症状严重程度，39项帕金森病调查表（PDQ-39）评价生活质量。Spearman秩相关分析探究RBD发病至出现帕金森病运动症状的时间间隔与其临床特征的相关性。结果 伴RBD组患者UPDRSⅢ评分（t=-2.703，P=0.008）和NMSS评分（t=-2.176，P=0.032）高于不伴RBD组；Spearman秩相关分析显示，RBD发病至出现帕金森病运动症状的时间间隔仅与NMSS评分呈正相关（r_s=0.547，P=0.001）。结论 伴RBD的帕金森病患者存在较严重的运动症状和非运动症状，且RBD出现越早、非运动症状越严重。

关键词: 帕金森病, REM睡眠行为障碍, 临床特征(非MeSH词)

Abstract: Objective To study the correlation between the time from rapid eye movement sleep behavior disorder (RBD) to disease onset and the clinical characteristics of Parkinson's disease (PD). Methods A total of 123 PD patients were recruited from Tianjin Huanhu Hospital between September 2019 and December 2021. All participants were divided into the group with RBD (41 cases) and the group without RBD (82 cases) according to the probable RBD criteria. Hoehn-Yahr staging was used to evaluate PD grade. Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) was used to evaluate the motor function of PD. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD), Parkinson's Disease Sleep Scale (PDSS), and Non-Motor Symptom Scale (NMSS) were used to evaluate cognitive function, anxiety, depression, sleep and total non-motor symptoms. The life quality of patients was evaluated by 39-Item Parkinson's Disease Questionnaire (PDQ-39). Spearman rank correlation analysis was used to explore the correlation between the time from RBD to disease onset and clinical characteristics in PD. Results UPDRS Ⅲ (t=-2.703, P=0.008) and NMSS (t=-2.176, P=0.032) scores of PD with RBD group were higher than those of the PD without RBD group. The time from the RBD to the onset of PD was positively correlated with NMSS score (r_s=0.547, P=0.001). Conclusions The motor and non-motor symptoms in PD patients with RBD are more severe than those of patients without RBD. Early onset of RBD in prodromal period may indicates more severe non-motor symptoms in future.

Key words: Parkinson disease, REM sleep behavior disorder, Clinical characteristic (not in MeSH)