帕金森病患者运动障碍的临床异质性

目的 研究帕金森病(PD)患者运动障碍的临床异质性.方法 依据主要运动障碍类型将98例PD分为震颇为主型(23例)、混合型(29例)和姿势异常步态障碍(PIGD)为主型(46例)三组,并比较他们的临床异质性.结果 震颤为主型PD多以震颤为首发症状.而PIGD为主型PD以强直、运动迟缓及步态障碍等为首发症状多见,且以左侧肢体首先受累较常见:震颤为主型PD的MMSE评分明显高于PIGD为主型(P<0.01);震颧为主型PD改良Hoehn-Yahr病情分级较轻(P=0.04);各型PD在性别、家族史与病程方面比较差异无显著性.结论 震颤为主型与姿势异常步态障碍为主型患者在首发与典型症状方面存在明显异质性.

Study of the clinical heterogeneity of movement disorder in Parkinson disease

OBJECTIVE: To investigate the clinical heterogeneity of movement disorder in Parkinson's disease (PD). METHODS: Ninety-eight PD patients (68 males and 30 females) were divided into tremor-dominant PD (n=23), mixed subtype PD (n=29) and postural instability and gait disorder (PIGD)-dominant PD (n=46) groups, and the clinical heterogeneity of the movement function of the patients was compared. RESULTS: The initial symptom of tremor-predominant PD was tremor, but patients with PIGD-dominant PD had rigidity and gait disorder as the initial symptoms, commonly compromising the left limb. The amended Hoehn-Yahr stage of tremor-dominant PD was significantly lower than that of the PIGD-dominant PD, while the score of Mini-Mental State Examination (MMSE) was significantly higher in the former. No statistical differences were found in the gender, course of disease and family history between the patients with different subtypes of PD. CONCLUSION: There are significant differences in the initial and typical symptoms between tremor-dominant PD and PIGD-dominant PD.