帕金森震颤患者肌电图特点分析

Analysis of the electromyographical character of Parkinson＇ s tremor

目的从帕金森震颤的频率、强度和药物反应的角度探寻帕金森震颤的肌电图特点。方法选取符合诊断标准的帕金森震颤患者66例，利用十导肌电图仪和标准化震颤分析软件TRAS采集帕金森病患者静止性震颤和姿势性震颤的频率和强度，比较帕金森静止性震颤和姿势性震颤之间频率、强度的差异有无统计学意义，帕金森震颤的频率、强度之间有无线性相关关系以及帕金森震颤患者规则用药前后震颤频率和强度的变化。结果帕金森静止性震颤较姿势性震颤的频率低，分别为（4．79±0．69）Hz和（5．54±1．18）Hz，差异具有统计学意义（F=33．5，P〈0．01），强度分别为0．016～421．700（mg）2和0．062～217．900（mg）2，差异无统计学意义（F=1．917，P〉0．05）；帕金森震颤的频率和强度之间无线性相关关系（r=0．09，P〉0．05）；帕金森病患者服药后的震颤强度较服药前明显降低，分别为0．016～421．700（mg）2和0．027—82．200（mg）2，差异具有统计学意义（F=5．179，P〈0．05），而服药前后的震颤频率分别为（5．09±0．85）Hz和（5．20±1．08）Hz，差异无统计学意义（F=0．474，P〉0．05）。结论帕金森静止性震颤和姿势性震颤可能存在着不同的震颤发生机制，帕金森震颤强度的易变性导致震颤频率与强度之间不具有线性相关性，药物治疗只能缓解帕金森震颤的症状，而对导致帕金森震颤的中枢性振荡器不具有逆转性作用。

Objective To investigate the electromyography characteristics of Parkinson＇ s disease （PD） by studying tremor frequency, intensity and drug response. Methods Sixty-six patients with PD hospitalized during March 2005 to May 2006 were re-evaluated and recruited into the study. A ten-channel electromyography recorded the frequency and intensity of the rest tremor and postural tremor. Tremor analysis soft was used to statistically analyze differences between the two types of tremor, correlation between the frequency and intensity, and changes after regular administration of dopaminergic medication. Results The frequencies of rest tremor （（4.79 ± 0.69） Hz） and postural tremor （（5.54 ± 1.18 ） Hz） showed statistical differences （ F = 33.5, P 〈 0. 01 ）, but the intensity of rest tremor （ 0. 016--421. 700 （mg） 2 ） and postural tremor （0. 062--217. 900 （mg）2）didn＇ t show statistical differences （F = 1. 917, P 〉 0. 05 ）. No regression relation was revealed between the frequency and intensity of tremor （ r = 0. 09, P 〉 0. 05 ）. After dopaminergic medication treatment, the intensity declined significantly from 0. 016---421. 700 （mg）2 to 0. 027--82. 200 （mg） 2 （ F = 5. 179, P 〈 0.05 ）, but the difference of frequencies of tremor between before （5.09±0.85） Hz） and after treatment （（5.20-±1.08） Hz） was not significant （F=0.474, P〉 0. 05）. Conclusions There may be different mechanisms for the rest tremor and postural tremor in PD. There is no correlation identified between the frequency and intensity in PD and this is may be resulted from variability of tremor intensity. Dopaminergic can relieve the symptom of tremor, but it doesn＇ t reduce the frequency of tremor.