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目的 探讨脑血管病及其危险因素在帕金森综合征发病中的作用 ,分析血管性帕金森综合征(VP)与帕金森病 (PD)的临床特点。方法 收集在我科住院的 86例帕金森综合征及PD ,根据有无高血压病、动脉硬化或脑卒中病史 ,分为VP组和PD组 ,并对两组的临床特点进行回顾性对比分析。结果 脑血管病及其危险因素在两组间的发生率有显著性差异 (P <0 .0 0 1) ,与PD组比较 ,VP组病人发病年龄偏大 (P <0 .0 1) ,临床表现以少动 -四肢强直为主 ,而静止性震颤少见 (P <0 .0 5 ) ,常伴发假性延髓麻痹、尿失禁 (P <0 .0 1)、智能障碍 (P <0 .0 0 1)等 ,头颅MRI以基底节区腔隙性脑梗死多见。且左旋多巴的治疗效果多不满意 (P<0 .0 5 )。结论 VP是病因、发病机理及临床特征不同于PD的一种帕金森综合征。
Objective To investigate the role of cerebrovascular disease and its risk factors in the pathogenesis of Parkinson’s disease and to analyze the clinical features of vascular Parkinson’s disease (VP) and Parkinson’s disease (PD). Methods Eighty-six Parkinson’s disease and PD were collected in our department. The patients were divided into VP group and PD group according to the presence or absence of hypertension, arteriosclerosis or stroke. The clinical features of the two groups were compared retrospectively . Results The incidence of cerebrovascular disease and its risk factors were significantly different between the two groups (P <0.01). Compared with the PD group, the patients in the VP group were older (P <0.01) The clinical manifestations were less active-limbs ankylosis, and resting tremor was rare (P <0.05), often accompanied by pseudobulbar paralysis, urinary incontinence (P <0.01), mental retardation (P <0) .0 0 1), etc., head MRI to basal ganglia lacunar infarction more common. And levodopa treatment more unsatisfactory (P <0. 05). Conclusion VP is a Parkinson’s disease with different etiology, pathogenesis and clinical features from PD.