血管性帕金森综合征与原发性帕金森病临床特点对比分析

Contrasting Analysis of Clinical Features between Vascular Parkinson’s Syndrom and Idiopathic Parkinson’s Disease

目的探讨血管性帕金森综合征（VP）与原发性帕金森病（PD）临床特点的区别。方法对2005年9月至2008年9月在大连大学附属新华医院确诊的VP患者54例与PD患者59侧的临床表现进行对比分析。结果VP患者大多有高血压病、脑卒中病史；VP组临床表现以偏瘫、对称性双下肢铅管样僵直为主，静止性震颤少见，可伴有椎体束损害和智能障碍，PD患者则以震颤、齿轮样强直为主。VP影像学表现为多发腔隙性脑梗死，不同于PD患者。抗PD药物治疗疗效优于VP。结论VP发病可能与长期高血压，腔隙性脑梗死有关，VP临床表现与PD不同，脑MRI或者头部CT检查有助于二者的鉴别。

Objective To explore the clinical difference of vascular Parkinson＇s syndrom （VP） and primar）＇ Parkinson＇s disease （PD）. Methods From September 2005 to September 2008 in Xinhua hospital of Dalian university, clinical manifestasion of VP（ n = 54 ） and PD （ n = 59 ） were retrospectively investiagated comparatively. Results Most of VP patients were accompanied by hypertension,stroke medical records; VP clinical manifestation was characterized as hemiparalysis, the symmetry of both lower limbs of lead-based-like stiffness, inactivity tremor, may be associated with pyramidal tract damage and mental retardation. PD patients were characterized as tremor, cogwheel rigidity. The imaging feature of VP showed multiple lacunar infarction, unlike in patients with PD. Treatment of Anti-PD drug had more effective than that of VP. Conclusion VP may be related to long-term hypertension, and lacunar infarction. Clinical manifestations of VP and PD were different, brain MRI or head CT examination contributed to the discrimination.