巴金森病与多系统萎缩患者的交感神经皮肤反应研究

目的：研究原发性巴金森病（IPD）与多系统萎缩（MSA）交感神经皮肤反应（SSR），以探讨它们自主神经功能障碍的差异。方法：对31例IPD、17例MSA和83位正常人的SSR结果比较，分析PD组和MSA组SSR异常特征和与病程、自主神经症状的相关性。结果：MSA组SSR异常率（76％）显著高于IPD组（45％），以双侧异常多见。3年内病程的SSR异常率为73％，并与自主神经症状相关。IPD组SSR异常与病程显著相关，与自主神经症状无完全对应关系，SSR异常更多见于震颤侧。结论：MSA广泛而严重的自主神经系统受累可能是SSR异常显著有别于IPD的基础。SSR异常出现早，呈双侧改变，且与自主神经症状有对应关系，则更多提示MSA的可能。

Study on sympathetic skin response in patients with idiopathic Parkinson's disease and multiple system atrophy

Objectives:To study the sympathetic skin response (SSR) in patients with idiopathic Parkinson'sdisease(IPD) and those with multiple system atrophy(MSA) and to explore the differences of autonomic dysfunctionbetween them. Methods:SSR was studied in 48 patients(31 with IPD and 17 with MSA) and 83 healthy control subjects.The characterishc of abnormal SSR and its relationship with the course of disease and autonomic symptoms wasanalysed. Results:The abnormality rate of SSR in MSA group was significantly higher than that of IPD(45% ), Bilateral abnormality of SSR was more frequent. The abnormality rate of SSR was 73% in patients with three-year course ofdisease, and was related to the automonic symtoms. In IPD group, the abnormal SSR was significantly correlated tothe course of disease but not to the autonomic symptoms. The abnormal SSR was more frequent in the tremor side. Conclusion:Significan differences of SSR between MSA and IPD might be based on the more severe and widespreadautonomic disturbance in MSA. The early presence, and bilateral changes of SSR which was associated with the autonomic symptoms might be more suggestive of MSA.