论文部分内容阅读
目的:探讨不宁腿综合征(RLS)患者经颅超声(TCS)的特点，分析其RLS严重程度自评量表(IRLS)评分及TCS参数与临床资料的相关性。方法:选择天津医科大学总医院睡眠障碍门诊自2020年9月至2021年1月收治的21例RLS患者作为RLS组，同期招募23例健康对照者作为对照组。采用IRLS评估RLS组患者的严重程度，采用14项汉密尔顿焦虑量表(HAMA-14)、24项汉密尔顿抑郁量表(HAMD-24)评估2组受试者的焦虑、抑郁状况，采用匹兹堡睡眠质量量表(PSQI)、失眠严重指数量表(ISI)、嗜睡自测量表(ESS)评估2组受试者的睡眠质量状况，采用TCS检查2组受试者黑质低回声、中缝核断裂的发生情况及第三脑室宽度，比较2组受试者的临床资料、TCS参数的差异，采用相关性分析检验RLS组患者IRLS评分、TCS参数与其临床特征的相关性。结果:与对照组比较，RLS组患者的HAMA-14、HAMD-24、ISI、PSQI评分均较高，差异均有统计学意义(n P<0.05)。与对照组比较，RLS组患者黑质低回声、中缝核断裂者所占比例均较高，差异均有统计学意义(n P<0.05)。RLS患者的IRLS评分与HAMA-14、HAMD-24、ISI评分均呈正相关关系(n P<0.05)。RLS患者的黑质低回声、第三脑室宽度与ESS评分均呈负相关关系(n rs=-2.005，n P=0.045；n r=-0.477，n P=0.029)。第三脑室宽度与男性、受教育年限均呈负相关关系(n rs=-0.592，n P=0.005；n rs= -0.627，n P=0.002)，与年龄、病程均呈正相关关系(n r=0.756，n P<0.001；n r=0.167，n P=0.047)。n 结论:RLS患者易合并焦虑、抑郁及睡眠障碍，TCS特征为黑质低回声和中缝核断裂。RLS严重程度可能会影响HAMA-14、HAMD-24、ISI评分。RLS患者性别、年龄、受教育年限、病程及ESS评分可能会影响TCS相关参数。“,”Objective:To investigate the characteristics of transcranial sonography (TCS) in patients with restless legs syndrome (RLS), and analyze the correlations of scores of RLS Self-rating Severity Scale by International Restless Leg Syndrome Study Group (IRLS) and TCS parameters with clinical data of these patients.Methods:Twenty-one patients with RLS admitted to the Sleep Disorder Clinic of our hospital from September 2020 to January 2021 were selected as RLS group, and 23 healthy controls at the same time period were recruited as control group. IRLS was used to evaluate the severity of patients in the RLS group, and the 14-item Hamilton anxiety rating scale (HAMA-14) and 24-item Hamilton depression rating scale (HAMD-24) were used to evaluate the anxiety and depression of subjects from the 2 groups. Pittsburgh Sleep Quality Scale (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were used to evaluate the sleep quality of subjects from the 2 groups. TCS was used to examine the occurrence of hypoechoic substantia nigra and raphe nucleus rupture and the width of the third ventricle in the two groups. The clinical data and TCS parameters of patients in the 2 groups were compared, and the correlations of IRLS scores and TCS parameters with clinical features of patients in the RLS group were analyzed.Results:As compared with those in the control group, the HAMA-14, HAMD-24, ISI and PSQI scores in the RLS group were statistically higher (n P<0.05). As compared with the control group, RLS group had significantly higher proportion of patients with hypoechoic substantia nigra or raphe nucleus rupture (n P<0.05). In RLS patients, the IRLS scores were positively correlated with HAMA-14, HAMD-24, and ISI scores (n P<0.05); ESS scores were negatively correlated with hypoechoic substantia nigra and width of the third ventricle (n rs=-2.005, n P=0.045; n r=-0.477, n P=0.029); width of the third ventricle was negatively correlated with gender (male) and years of education (n rs=-0.592, n P=0.005; n r=-0.627, n P=0.002), and positively correlated with age and course of the disease (n r=0.756, n P<0.001;n r=0.167, n P=0.047).n Conclusions:Patients with RLS are prone to anxiety, depression and sleep disorders; their TCS shows hypoechoic substantia nigra and raphe nucleus rupture. RLS severity may affect HAMA-14, HAMD-24, and ISI scores. Gender, age, years of education, course of disease, and ESS scores of RLS patients may affect TCS related parameters.