基底核钙化与节段性颅颈肌张力障碍关系的初步探讨:附90例报告

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目的:初步探讨基底核钙化(BGC)与节段性颅颈肌张力障碍(SCCD)的关系以及存在BGC的SCCD患者的临床特征。方法:回顾性分析2015年3月至2018年9月中日友好医院神经外科收治的90例SCCD患者(试验组)的临床资料。将同期门诊就诊的70例神经科疾病患者(包括30例缺血性脑血管病患者、18例痴呆患者、22例脑出血患者)以及20名健康人作为对照组。采用卡方检验比较两组患者BGC的发生率,并分析存在BGC的SCCD患者的临床特征。结果:试验组中BGC的发生率为38.9%(35/90),高于对照组的18.9%(17/90),两组的差异具有统计学意义(n χ2=8.762,n P=0.003)。存在BGC的SCCD患者中的女性患者所占比例(31/35)较无BGC的SCCD患者(30/55)更高,差异有统计学意义(n χ2=11.353,n P=0.001)。BGC在具有不同临床表现的SCCD患者中的比率(例)为:以单纯眼睑痉挛为主要表现的患者中占30.3%(10/33),眼睑痉挛合并口-下颌肌张力障碍的患者中占33.3%(13/39),除上述表现外同时合并颈部症状的患者中占12/18,三组间的差异具有统计学意义(n χ2=7.374,n P=0.025)。通过对比影像学结果发现,以单纯眼睑痉挛为主要表现的患者基底核区的钙化相对较轻,而同时合并眼睑痉挛、口-下颌肌张力障碍、颈部症状的患者其基底核区钙化程度较重,眼睑痉挛合并口-下颌肌张力障碍的患者基底核区的钙化程度介于上述两类型患者之间。n 结论:BGC与SCCD的发病可能有关;存在BGC的SCCD患者中,女性患者占大多数;受累部位越多,临床表现越复杂的SCCD患者BGC的阳性率越高,且钙化程度相对较重。“,”Objective:To investigate the relationship between basal ganglia calcification (BGC) and segmental craniocervical dystonia (SCCD) and to explore the clinical characteristics of SCCD patients with BGC.Methods:The clinical data of 90 SCCD patients (experimental group) admitted to Neurosurgery Department of China-Japan Friendship Hospital from March 2015 to September 2018 were retrospectively analyzed, and the outpatient patients with neurological diseases (including 30 patients with cerebrovascular disease, 18 patients with dementia, 22 patients with cerebral hemorrhage) and 20 healthy subjects were taken as the controls. Chi-square test was used to compare the incidence of BGC between the two groups, and the clinical characteristics of SCCD patients with BGC were analyzed.Results:The incidence of BGC in the experimental group was 38.9% (35/90), which was higher than that in the control group (18.9%, 17/90). The difference between the two groups was statistically significant (n χ2=8.762, n P=0.003). The proportion of female SCCD patients with BGC (31/35) was higher than that of SCCD patients without BGC (30/55), and the difference was statistically significant (n χ2=11.353, n P=0.001). The ratios of BGC in SCCD patients with various clinical manifestations was: 30.3% (10/33) in patients with blepharospasm mainly, 33.3% (13/39) in patients with blepharospasm combined with oral and mandibular dystonia, and 12/18 in patients with neck symptoms in addition to the manifestations as above. The difference between the three groups was statistically significant (n P<0.05). At the same time, comparative imaging results showed that BGC in patients with blepharospasm mainly was relatively mild, while that in patients with blepharospasm, oral and mandibular dystonia, and neck symptoms were more serious. The degree of BGC in patients with blepharospasm combined with oral and mandibular dystonia was between the above-mentioned two other types.n Conclusions:BGC may be related to the onset of SCCD. Female patients account for the majority of SCCD patients with BGC. SCCD patients with more involved sites and more complex clinical manifestations have higher positive rate of BGC and more serious calcification.
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