帕金森病患者的临床特征分析

Analysis of clinical characteristics in patients with Parkinson's disease

目的：分析帕金森病(PD)患者的早期临床表现和病程特征,为疾病的早期诊断及预防提供一些可能的线索。方法：采用问卷调查、体格检查及量表评分等方法,分析176例PD患者[平均年龄(65+9)岁]的发病、病程进展及其影响因素。结果：176例患者平均起病年龄(59±10)岁。以震颤起病者占44．32%(n=78),平均起病年龄(57±10)岁：以强直一少动起病者占42．05%(n=74),平均起病年龄(61±9)岁；混合起病患者占13．64%(n=24)。73．3%患者偏侧起病,其中以上肢起病者占46．02%。从首发一侧肢体波及至对侧肢体平均时间(30．61±34．71)月；从首发症状开始进展至轻度(Hoehn-Yahr 1～2级)平均(5．47±4．22)年,至中重度平均病程为(7．15±4．86)年。结论：PD以震颤或强直单一起病形式为主,且单侧起病；震颤起病患者起病年龄较轻,随年龄增大,震颤起病患者比例减少,而以强直-少动起病患者比例增多：震颤起病患者的病情进展较强直-少动型为慢。

Objective To investigate the clinical characteristics, progression of the Parkinson＇ s disease （PD） in order to provide some clues for early diagnosis and prophylaxis. Methods One hundred and seventy-six patients [average age （65±9）years] with idiopathic Parkinson＇s disease were studied by questionnaire, physical examination and rating scales. Results The average age at onset of 176 cases （107 men and 69 women） was （59±10）years. Seventy-eight patients （44.32%） had a tremor as initial symptom with the average age of （57±10）years. Seventy-four patients （42.05%） manifested an akinesia-rigidity with the average age of （61±9） years, and 24 patients （13.64%） showed both the tremor and the akinesiarigidity. Most of cases （73.3%） manifested symptom（s） from one side. The upper limb was involved in 46.02% of the cases, especially in the patients with the initial symptom of tremor. The mean course from symptom （s） of one side to the other side was （30.61±34.71） months. The mean course of disease from initial symptom（s） to the Hoehn-Yahr Ⅰ - Ⅱ was （5.47± 4.22 ）years, and to the Hoehn-Yahr〉 Ⅱ was （7.15±4.86） years. Conclusions The initial symptom of PD is usually the tremor or the akinesia-rigidity, predominantly starting from the unilateral limb. The incidence of tremor gradually reduces with age, while the incidence of akinesia-rigidity gradually increases with age. The progression of PD with the initial symptom of tremor seems slower than that of PD with initial symptom of akinesia-rigidity.