摘要：

目的: 探讨帕金森病患者血清胆红素与睡眠障碍的相关性。方法: 纳入2021年10月至2022年10月河南省人民医院收治的79例帕金森病患者以及性别、年龄相匹配的77例对照者，采用统一帕金森病评价量表第三部分（UPDRSⅢ）评价运动症状、改良Hoehn-Yahr分期评价疾病严重程度、快速眼动睡眠期行为障碍问卷香港版（RBDQ-HK）评价快速眼动睡眠期行为障碍严重程度、匹兹堡睡眠质量指数（PSQI）评价睡眠质量、Epworth嗜睡量表（ESS）评价日间过度思睡，测定血清总胆红素、间接胆红素和直接胆红素水平。结果: 根据改良Hoehn-Yahr分期分为早期帕金森病组（47例）和中晚期帕金森病组（32例），两组总胆红素（Z=4.988，P=0.000；Z=3.917，P=0.000）、间接胆红素（Z=4.860，P=0.000；Z=3.827，P=0.000）、直接胆红素（Z=4.054，P=0.000；Z=3.468，P=0.002）均低于对照组。相关分析结果显示，帕金森病患者血清总胆红素与PSQI评分（r=-0.310，P=0.006）和ESS评分（r=-0.254，P=0.027）呈负相关关系；间接胆红素与PSQI评分呈负相关关系（r=-0.284，P=0.013）；直接胆红素与RBDQ-HK评分（r=-0.244，P=0.034）、PSQI评分（r=-0.288，P=0.012）和ESS评分（r=-0.295，P=0.010）呈负相关。结论: 帕金森病患者血清胆红素水平降低，推测其可能是帕金森病的潜在发病机制，且胆红素水平越低、帕金森病患者睡眠障碍越严重。

关键词: 帕金森病, 睡眠觉醒障碍, 胆红素

Abstract:

Objective: To explore correlation between serum bilirubin and sleep disorders in Parkinson's disease (PD) patients. Methods: Total 79 PD cases from He'nan Provincial People's Hospital, and 77 age and sex matched controls were recruited from October 2021 to October 2022. The Unified Parkinson Disease Rating Scale Ⅲ (UPDRSⅢ) was used to evaluate motor symptoms, modified Hoehn-Yahr staging was used to evaluate disease severity, Rapid Eye Movement Sleep Behavior Disorder Questionaire-Hong Kong (RBDQ-HK) was used to access the severity of rapid eye movement sleep behavior disorder (RBD), Pittsburgh Sleep Quality Index (PSQI) was used to access the sleep quality, and Epworth Sleepiness Scale (ESS) was used to access the occurrence of excessive daytime sleepiness (EDS). The levels of serum total bilirubin (TBIL), indirect bilirubin (IBIL) and direct bilirubin (DBIL) were measured. Results: Seventy-nine PD patients were divided into the early PD group (n=47) and middle-late PD group (n=32). The levels of TBIL (Z=4.988, P=0.000; Z=3.917, P=0.000), IBIL (Z=4.860, P=0.000; Z=3.827, P=0.000) and DBIL (Z=4.054, P=0.000; Z=3.468, P=0.002) in the early PD group and middle-late PD group were lower than those in the control group. Correlation analysis showed serum TBIL levels were negatively correlated with PSQI score (r=-0.310, P=0.006) and ESS score (r=-0.254, P=0.027), serum IBIL levels were negatively correlated with PSQI score (r=-0.284, P=0.013), serum DBIL levels were negatively correlated with RBDQ-HK score (r=-0.244, P=0.034), PSQI score (r=-0.288, P=0.012) and ESS score (r=-0.295, P=0.010). Conclusions: Serum bilirubin in PD patients were lower than those in the control group inferring that a decrease in serum bilirubin might be a potential mechanism for the occurrence of PD. The lower serum bilirubin was, the more severe sleep disorders in PD patients were.

Key words: Parkinson disease, Sleep wake disorders, Bilirubin