合并静止性震颤的原发性震颤患者临床特点分析

目的了解北京地区社区中老年人原发性震颤(essential tremor,ET)的临床特征及其与预后的关系。方法2000年在北京城区、近郊平原、远郊山区调查了2835名55岁以上中老年人,采用筛查和临床诊断两步法确诊患者。发现ET患者135例,对其中合并静止性震颤的患者进行分析,并于2004年对其进行随访。结果其中合并上肢静止性震颤患者17例,占12.6%,合并静止性震颤组震颤总分、头部震颤的比例、肢体震颤总分均明显高于对照组。两组年龄、性别组成、病史无显著性差异,姿势性震颤和动作性震颤的程度差异不明显。4年后随访到13例(13/17),其中3例死亡,实际调查的10例中有9例仍诊断为ET,另1例诊断为临床很可能ET。结论有相当部分社区ET患者可以合并静止性震颤,合并静止性震颤的患者提示病情较重。

The clinical characteristics of essential tremor with rest tremor in the elderly

Objective To investigate the clinical feature of essential tremor (ET) with rest tremor of the elderly in Beijing and study the prognosis.Methods Using a door-to-door,two-phase screen approach,we investigated 2835 residents older than 55 years old from rural,urban and mountain areas of Beijing in 2000.135 ET patients were found in the investigation.We made an analysis of the patients who had rest tremor and made a follow-up study in 2004.Results 17 of 135 ET patients (12.6%) had rest tremor.Compared with the 118 ET patients without rest tremor,these 17 had disease of greater severity and more head affected.Also,these ET were more widely disseminated,as evidenced by a larger proportion with head tremor.There was no difference between the two groups in age,gender and history,neither in the severity of postural nor action tremor.13 patients were followed up after 4 years.3 patients died while the other 9 patients were diagnosed as ET and 1 was diagnosed as probable ET.Conclusions 12.6% patients with ET had rest tremor.The tremor was associated with disease that was more severe,more disseminated.