帕金森病50例皮肤交感反应特点分析

目的分析帕金森病（PD）患者的皮肤交感反应（SSR）的特点,并探讨其与自主神经损害的关系。方法收集2008年6月~2012年1月我院门诊或病房收治的PD患者50例,同时收集年龄、性别匹配的健康人50例,均采用常规肌电图检查,测定其运动神经传导、F波、感觉神经传导（SCV）和SSR。结果正常对照组SSR全部引出,50例PD患者中,上肢5例波形缺失,下肢16例波形缺失。SSR潜伏期：正常对照组上肢（1.33±0.04）s,下肢（1.99±0.38）s,PD组上肢（1.50±0.11）s,下肢（2.16±0.17）s,两组比较差异有高度统计学意义（P〈0.01）。SSR波幅：正常对照组上肢（3.31±2.15）mv,下肢（1.73±0.98）mv,PD组上肢（1.23±0.67）mv,下肢（0.72±0.45）mv,两组比较差异有高度统计学意义（P〈0.01）。在50例PD患者中,SSR异常35例（70%）,其中上肢异常10例,下肢异常35例,上肢SR异常的患者,其下肢SSR均有异常。下肢异常率明显高于上肢,二者比较差异有高度统计学意义（P〈0.01）。PD患者SSR异常主要表现在：波形消失16例,潜伏期延长7例,波幅下降19例。自主神经损伤症状组SSR异常率明显高于无自主神经损伤症状组。结论 PD患者可出现SSR的异常,SSR能为PD的自主神经功能受损提供依据。

Sympathetic skin response studies of Parkinson disease in 50 patients

Objective To investigate the features of sympathetic skin response in patients with Parkinson disease and explore the correlation between SSR and automatic dysfunction.Methods The data of outpatients and inpatients diagnosed with PD were collected in the second affiliated hospital of Dalian Medical University from June 2008 to January 2012.Sympathetic skin response were measured in median nerve.Parameters analyses mainly included SSR latency and amplitude.Results The SSR was present in 100% of the controls but was absent in 5 cases in the hands and 16 cases in the feet in PD patients.The mean latency of the PD patients [palmar SSR:(1.50±0.11)s,plantar SSR:(2.16±0.17)s] were longer than that of the controls [palmar SSR:(1.33±0.04)s,plantar SSR:(1.99±0.38)s](P < 0.01).The mean amplitudes of the PD patients [palmar SSR:(1.23±0.67) mv,plantar SSR:(0.72±0.45) mv] were lower than that of the controls [palmar SSR:(3.31±2.15) mv;plantar SSR:(1.73±0.98) mv](P < 0.01).The abnormality rate of SSR was 70% in 50 PD patients,10 cases in the hands,35 cases in the legs.The abnormality of SSR in automatic dysfunction group was higher than that of nonautomatic dysfunction group(P < 0.01).The abnormality of SSR included prolonged latencies,decreased amplitudes and wave absence.Conclusion An abnormal SSR can been observed in PD.The autonomic nervous system in PD patients may be early detected by the SSR.