| Objectives:Through the observation of the clinical case studies,we will sum up the clinical features of and CM syndrome features of sleep disorders in Wilson disease,and provide the bases for clinical diagnoses and treatments.Methods:Adopting the method of control study,we select 220 cases of Wilson disease met inclusion criteria as WD group and 30 cases of person whose demographic date is match with the WD group's as the control group.We collect the data of general situation,Pittsburgh Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS)and Self-Rating Scale of Sleep(SRSS),evaluate the patients for syndrome differentiation by CM syndrome scale.Logistic multiple regression is used to analyze the relationship between Wilson disease and syndrome elements and discuss the clinical features of sleep disorders in Wilson disease and the relationship between the CM syndromes.Results:1.The WD group has 126 patients with sleep disorders(57.27%),with 94 cases without sleep disorders(42.73%).In the control group,there are 8 people with sleep disorders(26.67%)and 22 people without sleep disorders(73.33%).The incidence of sleep disorders in WD group is significantly higher than that in the control group,and there is significant statistical difference between the two groups(P<0.01).2.In WD group,there are 86 cases(39.09%)of difficulty in falling asleep,97cases(44.09%)of those who get nocturnal wakefulness,102 cases(46.36%)of early morning awakening,95 cases(43.18%)of those who have nocturnal dreams,61cases(27.73%)of the daytime drowsines and 36 cases(16.36%)with RLS.As for control group,there are 7 cases(23.33%)of difficulty in falling asleep,4 cases(13.33%)of those who get nocturnal wakefulness,6 cases(20.00%)of early morning awakening,6cases(20.00%)of those who have nocturnal dreams,3 cases(10.00%)of the daytime drowsines and 1 cases(3.33%)with RLS.After statistical analysis,the incidence of various clinical manifestations in WD group is significantly higher than that in the control group,and the comparison between the two groups is statistically significant(P<0.05).3.The mean values of PSQI,ESS and SRSS in WD group are: 8.66±3.62,7.49±3.05 and 24.52±6.71.The mean values of PSQI,ESS and SRSS in the control group are:6.43±3.09,5.27±2.98 and 22.56±5.04.The mean values of PSQI,ESS and SRSS in WD group are higher than that in the control group(t = 3.213,3.828,2.327;P=0.001,0.000,0.021).4.The average age of WD with sleep disorders(29.56±8.76years)is higher than that of those with no sleep disorders(23.46 ± 7.43years),showing a significant difference(P<0.01).The average course of disease of WD with sleep disorders(7.72±6.46years)is longer than that without sleep disorders(4.30 ± 4.46years),showing a significant difference(P<0.01).There is a significant difference(P<0.01)between the average dominant symptoms of WD with(3.88 ± 1.38)and without sleep disorders(2.97 ±1.42).The incidence of brain types of sleep disorder in WD is higher than that of liver types,and the incidence of women is higher than that of men,with a statistically significant difference(P<0.05).There is no statistically difference in contrast of years of education and careers between two groups(P>0.05).5.Among the 8 syndrome elements,the frequency of Tanshi is 196,with the frequency of sleep disorders being 140(71.43%).The frequency of Huore is 45,among which the frequency of sleep disorders is 41(91.11%).The frequency of Qiyu is 9,and the frequency of sleep disorders is 5(55.56%).The frequency of Xueyu is 153,and the frequency of sleep disorders is 60(39.22%).The frequency of Xuexu is 21,and the frequency of sleep disorders is 11(52.38%).The frequency of Yinxu is 7,and the frequency of sleep disorders is 6(85.71%).The frequency of Yangxu appears 6 times,and the frequency of sleep disorders is 4(66.67%).The frequency of Yangkang appeared 2times,among which the frequency of sleep disorders is 1(50.00%).Using Logistic regression to analysis the risk of the syndrome elements of sleep disorders in Wilson disease,results show that the regression coefficients of Tanshi,Huore,Yinxu are 8.238,9.493 and 10.152,with a statistically significant(P< 0.05).6.Of the 220 Wilson disease patients,54 patients are identified as Shireneiyun group.Among them,43 patients have sleep disorders,and the incidence of sleep disorders is79.63%.Among the 144 cases of Tanyuhujie group,69 patients have sleep disorders and the incidence of sleep disorders is 47.92%.7 cases are Ganshenyinkui group,including 5cases of sleep disorders and the incidence of sleep disorders is 71.43%.9 cases of syndrome differentiation are Ganqiyujie group,among which 5 patients have sleep disorders and the incidence of sleep disorders is 55.56%.6 cases of syndrome differentiation are Pishenyangxu group,among which 4 patients have sleep disorders,and the incidence of sleep disorders is 66.67%.The incidence of 5 types of WD sleep disorders are different,tested by the Chi-square test(P<0.01).Conclusion:1.Wilson disease and sleep disorders are frequently associated with each other in clinical.The incidence of sleep disorders in Wilson disease is high,and clinicians should pay more attention and cognition.2.The main clinical manifestations of sleep disorders in Wilson disease are insomnia,including difficulty in falling asleep,nocturnal wakefulness,early morning awakening,and nocturnal dreams.3.The older the age,the longer the duration of the disease and the more dominant symptoms,the more likely the patient is to have a sleep disorder.The proportion of brain types of sleep disorder in Wilson disease is higher than that of liver types,and the incidence of women is higher than that of men.4.In the 8 syndrome elements of Tanshi,Xueyu,Huore,Xuexu,Qiyu,Yinxu,Yangxu and Yangkang,the main risk factors of sleep disorders in Wilson disease are Yinxu,Huore and Tanshi.5.In the 5 syndromes of Shireneiyun group,Tanyuhujie group,Ganshenyinkui group,Ganqiyujie group and Pishenyangxu group,the syndromes of Shireneiyun group and Ganshenyinkui group are the main syndromes of sleep disorders in Wilson disease. |
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