多系统萎缩的临床症状及早期诊断的价值体会
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摘要
目的探讨多系统萎缩的临床症状及早期诊断的价值。方法选取该院24例多系统萎缩病例进行回顾性分析,时间区间为2017年5月—2018年5月。8例多系统萎缩患者以MSA-P(帕金森综合征)为对照组;16例多系统萎缩患者以MSA-C(小脑性共济失调)为观察组。对比两组患者首发症状及临床特点。结果 MSA-P组首发症状包括头晕、运动迟缓、震颤、肌强直、行走不稳;MSA-C组首发症状包括头晕、行走不稳、构音障碍、下肢无力、肌强直;MSA-P组自主神经功能障碍头晕例数为1例(12.50%),便秘例数为2例(25.00%),体位性低血压2例(25.00%)。帕金森症状震颤例数为4例(50.00%),肌强直例数为6例(75.00%),运动迟缓7例(87.50%),姿势步态异常3例(37.50%)。小脑共济失调症状行走不稳例数为3例(37.50%),下肢无力1例(12.50%),颅脑磁共振小脑、脑桥萎缩2例(25.00%),第四脑室脑桥小脑脚环池扩1例(12.50%),大脑半球萎缩例数为5例(62.50%)。MSA-C组自主神经功能障碍头晕例数为12例(75.00%),便秘例数为5例(31.25%),体位性低血压10例(62.50%)。帕金森症状震颤例数为3例(18.70%),肌强直例数为2例(12.50%),运动迟缓4例(25.00%),姿势步态异常2例(12.50%)。小脑共济失调症状行走不稳例数为14例(87.50%),下肢无力8例(50.00%),颅脑磁共振小脑、脑桥萎缩9例(56.25%),第四脑室脑桥小脑脚环池扩5例(31.25%),大脑半球萎缩例数为2例(12.50%)。结论多系统萎缩无特殊治疗方法,预后差,少数药物一定程度上可改善部分多系统萎缩患者临床症状。
Objective To investigate the clinical symptoms and early diagnosis of multi-system atrophy. Methods A retrospective analysis of 24 cases of multiple system atrophy in our hospital was performed. The time interval was from May 2017 to May 2018. Eight pa-tients with multiple system atrophy were treated with MSA-P(Parkinson's syndrome) as the control group; 16 patients with multiple system atrophy were treated with MSA-C(cerebellar ataxia). The first symptoms and clinical features of the two groups were com-pared. Results The first symptoms in the MSA-P group included dizziness, bradykinesia, tremor, muscle rigidity, and unstable walk-ing. The first symptoms in the MSA-C group included dizziness, unstable walking, dysarthria, lower extremity weakness, and muscle rigidity; MSA-P group of the number of dizziness in autonomic dysfunction was 1 case(12.50%), the number of constipation cases was 2 cases(25.00%), and orthostatic hypotension was 2 cases(25.00%). The number of Parkinson's symptoms of tremor was 4(50.00%), the number of myotonia was 6 cases(75.00%), 7 cases(87.50%) were retarded, and 3 cases(37.50%) were abnormal gait.Cerebellar ataxia symptoms were unstable in 3 cases(37.50%), lower extremity weakness in 1 case(12.50%), brain magnetic reso-nance cerebellum, pons atrophy in 2 cases(25.00%), fourth ventricle pons cerebellar foot ring pool of 1 case(12.50%), the number of cases of cerebral hemisphere atrophy was 5 cases(62.50%). The number of dizziness in autonomic dysfunction in MSA-C group was12 cases(75%), 5 cases in constipation(31.25%), and 10 cases in orthostatic hypotension(62.50%). The number of Parkinson's symp-tom tremors was 3 cases(18.70%), the number of myotonia was 2 cases(12.50%), 4 cases(25.00%) were retarded, and 2 cases(12.50%) were abnormal gait. The cerebellar ataxia symptoms were unstable in 14 cases(87.50%), lower extremity weakness in 8 cas-es(50.00%), cranial magnetic resonance cerebellum, pons atrophy in 9 cases(56.25%), fourth ventricle pons cerebellar foot ring pool of 5 cases(31.25%), the number of cases of cerebral hemisphere atrophy was 2 cases(12.50%). Conclusion There is no special treat-ment for multi-system atrophy, and the prognosis is poor. A few drugs can improve the clinical symptoms of some patients with multi-ple system atrophy.
Objective To investigate the clinical symptoms and early diagnosis of multi-system atrophy. Methods A retrospective analysis of 24 cases of multiple system atrophy in our hospital was performed. The time interval was from May 2017 to May 2018. Eight pa-tients with multiple system atrophy were treated with MSA-P(Parkinson's syndrome) as the control group; 16 patients with multiple system atrophy were treated with MSA-C(cerebellar ataxia). The first symptoms and clinical features of the two groups were com-pared. Results The first symptoms in the MSA-P group included dizziness, bradykinesia, tremor, muscle rigidity, and unstable walk-ing. The first symptoms in the MSA-C group included dizziness, unstable walking, dysarthria, lower extremity weakness, and muscle rigidity; MSA-P group of the number of dizziness in autonomic dysfunction was 1 case(12.50%), the number of constipation cases was 2 cases(25.00%), and orthostatic hypotension was 2 cases(25.00%). The number of Parkinson's symptoms of tremor was 4(50.00%), the number of myotonia was 6 cases(75.00%), 7 cases(87.50%) were retarded, and 3 cases(37.50%) were abnormal gait.Cerebellar ataxia symptoms were unstable in 3 cases(37.50%), lower extremity weakness in 1 case(12.50%), brain magnetic reso-nance cerebellum, pons atrophy in 2 cases(25.00%), fourth ventricle pons cerebellar foot ring pool of 1 case(12.50%), the number of cases of cerebral hemisphere atrophy was 5 cases(62.50%). The number of dizziness in autonomic dysfunction in MSA-C group was12 cases(75%), 5 cases in constipation(31.25%), and 10 cases in orthostatic hypotension(62.50%). The number of Parkinson's symp-tom tremors was 3 cases(18.70%), the number of myotonia was 2 cases(12.50%), 4 cases(25.00%) were retarded, and 2 cases(12.50%) were abnormal gait. The cerebellar ataxia symptoms were unstable in 14 cases(87.50%), lower extremity weakness in 8 cas-es(50.00%), cranial magnetic resonance cerebellum, pons atrophy in 9 cases(56.25%), fourth ventricle pons cerebellar foot ring pool of 5 cases(31.25%), the number of cases of cerebral hemisphere atrophy was 2 cases(12.50%). Conclusion There is no special treat-ment for multi-system atrophy, and the prognosis is poor. A few drugs can improve the clinical symptoms of some patients with multi-ple system atrophy.
引文
[1]叶欢,赵中.多系统萎缩的临床诊治进展[J].中国综合临床, 2016, 32(11):1045-1048.
[2]王栗实,陈璐,任珊,等.温肾健脑经验方治疗多系统萎缩的临床疗效观察[J].中华中医药杂志, 2017,12(5):2005-2010.
[3]杨晖,沈智辉,徐白萱. 11C-CFT PET/CT显像鉴别多系统萎缩与帕金森病的价值[J].中国医学影像学杂志, 2017,25(5):349-353.
[4]尹顺雄,唐妍妍,闵连秋.多系统萎缩误诊为原发性帕金森病一例报道及诊断思路分析[J].中国全科医学, 2018,21(21):35-37.
[5]李哲贤,宋伟强,刘袁颖,等.多系统萎缩P型与帕金森病患者临床特征及认知功能的比较研究[J].实用心脑肺血管病杂志, 2016, 24(8):24-28.
[6]吴兴华,王志伟,戚晓昆.电生理检测在多系统萎缩与帕金森病诊断及鉴别诊断中的研究进展[J].中华老年心脑血管病杂志, 2016, 18(12):1337-1339.
[7]王粟实,陈路,江墨,等.多系统萎缩证候分析及中医药治疗进展[J].北京中医药, 2016,23(12):1180-1184.
[8]刘平,姜树军,刘鲜萍.多系统萎缩18例临床特征分析及早期诊断[J].中华保健医学杂志, 2016, 12(6):467-469.
[2]王栗实,陈璐,任珊,等.温肾健脑经验方治疗多系统萎缩的临床疗效观察[J].中华中医药杂志, 2017,12(5):2005-2010.
[3]杨晖,沈智辉,徐白萱. 11C-CFT PET/CT显像鉴别多系统萎缩与帕金森病的价值[J].中国医学影像学杂志, 2017,25(5):349-353.
[4]尹顺雄,唐妍妍,闵连秋.多系统萎缩误诊为原发性帕金森病一例报道及诊断思路分析[J].中国全科医学, 2018,21(21):35-37.
[5]李哲贤,宋伟强,刘袁颖,等.多系统萎缩P型与帕金森病患者临床特征及认知功能的比较研究[J].实用心脑肺血管病杂志, 2016, 24(8):24-28.
[6]吴兴华,王志伟,戚晓昆.电生理检测在多系统萎缩与帕金森病诊断及鉴别诊断中的研究进展[J].中华老年心脑血管病杂志, 2016, 18(12):1337-1339.
[7]王粟实,陈路,江墨,等.多系统萎缩证候分析及中医药治疗进展[J].北京中医药, 2016,23(12):1180-1184.
[8]刘平,姜树军,刘鲜萍.多系统萎缩18例临床特征分析及早期诊断[J].中华保健医学杂志, 2016, 12(6):467-469.