《中国康复理论与实践》

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (7): 757-762.doi: 10.3969/j.issn.1006-9771.2018.07.002

• 专题 • 上一篇    下一篇

特发性震颤与特发性震颤发展成帕金森病患者的临床特征比较

王雪梅, 曹振汤, 柳竹, 马惠姿, 王展, 杨雅琴, 冯涛   

  1. 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;
    2.国家神经系统疾病临床医学研究中心,北京市 100050;
    3.北京脑重大疾病研究院帕金森病研究所,北京市 100050
  • 收稿日期:2018-05-22 修回日期:2018-06-08 出版日期:2018-07-25 发布日期:2018-08-01
  • 通讯作者: 冯涛。E-mail: happyft@sina.com
  • 作者简介:王雪梅(1978-),女,汉族,北京市人,博士,副主任医师,主要研究方向：帕金森病的临床与基础研究。通讯作者：冯涛,男,博士,主任医师、教授。
  • 基金资助:
    1.国家自然科学基金面上项目(No. 81571226; No. 81771367); 2.首都特色临床应用研究(No.Z171100001017041); 5.北京市科委基金项目(No. Z151100003915150); 3.“十三五”国家重点研发计划(No. 2016YFC1306501)

Features of Essential Tremor and Parkinson's Disease Developed from Essential Tremor

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

  1. 1. Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
    2. China National Clinical Research Center for Neurological Disease, Beijing 100050, China;
    3. Parkinson's Disease Center, Beijing Institute for Brain Disorder, Capital Medical University, Beijing 100050, China
  • Received:2018-05-22 Revised:2018-06-08 Published:2018-07-25 Online:2018-08-01
  • Contact: FENG Tao. E-mail: happyft@sina.com
  • Supported by:
    Supported by National Natural Science Foundation of China (General) (No. 81571226 and No. 81771367), Capital Clinical Application Research Program (No. Z171100001017041), Beijing Science and Technology Commission Fund (No. Z151100003915150) and National Key Research and Development Program of the 13th Five-Year Plan (No. 2016YFC1306501)

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摘要： 目的 探讨特发性震颤(ET)患者与ET发展为帕金森病(ET-PD)患者的震颤特征和非运动症状的差异。方法 2016年3月至2017年8月,对30例ET患者和17例ET-PD患者采用一般情况调查表、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、简易精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)进行评定,检测黑质超声及静止性、姿势性震颤的频率、振幅和形式。结果 相比ET患者,ET-PD患者更多出现嗅觉减退、快速眼动期睡眠行为障碍 (χ2>4.656, P<0.05);黑质强回声面积更高(t=-2.164, P<0.05);下肢震颤及下颌震颤发生率明显升高 (χ2>8.745, P<0.01);头部和上肢静止性及姿势性震颤的频率较低 (t>2.082, P<0.05)。ET患者上肢静止性、姿势性震颤均以同步收缩为主,ET-PD患者以交替收缩为主(χ2>3.943, P<0.05)。结论 ET患者与ET-PD患者非运动症状和震颤各具特点,当ET患者出现嗅觉减退,快速眼动期睡眠行为障碍,震颤部位、频率、收缩型式发生变化时,需警惕发展成帕金森病的可能。

关键词: 特发性震颤, 帕金森病, 非运动症状, 震颤, 震颤分析

Abstract: Objective To compare the characteristics of tremor and non-motor symptoms in patients with essential tremor (ET) and patients with Parkinson's disease developed from essential tremor (ET-PD). Methods From March, 2016 to August, 2017, 30 ET patients and 17 ET-PD patients were investigated with the general questionnaire, Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and were measured with transcranial sonography and the frequency, amplitude and contraction patterns of resting and postural tremors. Results Compared with the ET patients, there were more patients reported olfactory dysfunction and rapid eye movement behavior disorder (RBD) in ET-PD patients (χ2>4.656, P<0.05). Meanwhile, the area of hyperechogenicity in substantia nigra was greater (t=2.164, P<0.05), the incidence of lower limb tremor and mandibular tremor was more (χ2>8.745, P<0.01), the frequency of rest and postural tremor in the head and upper limbs was less (t>2.082, P<0.05). The rest and postural tremors in the upper limbs were mainly synchronous in ET patients, whereas it was alternating in ET-PD patients (χ2>3.943, P<0.05). Conclusion Some differences of non-motor symptoms and tremor are found in patients with ET-PD and ET. When ET patients suffer from hyposmia, RBD, or the site, frequency and contraction patterns of tremor changes, they may develop to PD.

Key words: essential tremor, Parkinson's disease, non-motor symptoms, tremor, tremor analysis

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