《中国康复理论与实践》

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (3): 319-322.doi: 10.3969/j.issn.1006-9771.2018.03.014

• 临床研究 • 上一篇    下一篇

早发型与晚发型帕金森病震颤特征比较

柳竹, 冯涛, 王雪梅, 王展, 杨雅琴, 马惠姿   

  1. 首都医科大学附属北京天坛医院神经病学中心神经变性病科,北京市 100050
  • 收稿日期:2017-12-12 修回日期:2018-01-11 出版日期:2018-03-25 发布日期:2018-03-27
  • 通讯作者: 马惠姿。E-mail: mahuizi1127@126.com
  • 作者简介:柳竹(1984-),女,汉族,浙江湖州市人,博士,医师,主要研究方向：神经变性病。通讯作者：马惠姿,女,硕士,副主任医师。
  • 基金资助:
    国家自然科学基金项目(No. 81771367)

Characteristics of Tremor in Young or Late Onset Parkinson's Disease

LIU Zhu, FENG Tao, WANG Xue-mei, WANG Zhan, YANG Ya-qin, MA Hui-zi   

  1. Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2017-12-12 Revised:2018-01-11 Published:2018-03-25 Online:2018-03-27
  • Contact: MA Hui-zi. E-mail: mahuizi1127@126.com
  • Supported by:
    Supported by National Natural Science Foundation of China (No. 81771367)

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摘要： 目的 探讨早发型帕金森病(YOPD)与晚发型帕金森病(LOPD)患者震颤的特征和急性左旋多巴冲击试验改善率的差异。方法 2017年3月至9月,至少有一侧肢体存在静止性或姿势性震颤的帕金森病住院患者70例,根据发病年龄分为YOPD组(n=23)和LOPD组(n=47),行震颤分析和急性左旋多巴冲击试验,分别检测患者静止、姿势及持物1000 g震颤的优势频率、振幅及震颤节律形式。结果 YOPD组较LOPD组年龄小(t=-2.423, P<0.01),H-Y分期病情较轻(χ2=-4.604, P<0.05),病程早期(≤5年) 左旋多巴等效剂量较少(t=-2.119, P<0.05)。静止性震颤频率4~6 Hz的患者数,YOPD组多于LOPD组(χ2=3.896, P<0.05)。LOPD组强直与运动迟缓评分与病程呈正相关(r=0.34, P<0.05),而YOPD组无明显相关性。结论 YOPD多表现为经典帕金森震颤,震颤分析可以帮助年轻震颤患者鉴别病因。YOPD和LOPD均对左旋多巴反应有较好反应,YOPD早期用量较少。

关键词: 早发型帕金森病, 晚发型帕金森病, 震颤, 急性左旋多巴冲击试验, 震颤分析

Abstract: Objective To compare the characteristics of tremor and improvement after acute levodopa challenge test in young onset Parkinson's disease (YOPD) and late onset Parkinson's disease (LOPD) with a cross-sectional study. Methods From Match to September, 2017, 70 Parkinson's disease inpatients with rest or postural tremor in at least one extremity were included, in which 23 patients were in YOPD group, and other 47 in LOPD group according to their ages of onset. They finished acute levodopa challenge test and were analyzed for dominant tremor frequency, amplitude and rhythm under resting state, posturing and holding 1000 grams state, respectively. Results YOPD group was younger (t=-2.423, P<0.01) with lower Hoehn-Yahr stage (χ2=-4.604, P<0.05), and needed less equivalent dose of levodopa at early stage (first five years) (t=-2.119, P<0.05). There was a bigger ratio of patients with rest tremor in frequency of four to six Hz in YOPD group than in LOPD group (χ2=3.896, P<0.05). Rigidity and bradykinesia scores of LOPD group positively correlated with the course of disease (r=0.34, P<0.05), while it was not found in YOPD group.Conclusion Tremor expresses most in the classical way in YOPD patients, and tremor analysis could help to diagnose young adults. Both YOPD and LOPD patients get well in acute levodopa challenge test, while YOPD patients need less equivalent dose of levodopa at early stage.

Key words: young onset Parkinson's disease, late onset Parkinson's disease, tremor, acute levodopa challenge test, tremor analysis

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