震颤分析对早期帕金森病震颤和生理性震颤的鉴别

Difference of the tremor of Parkinson's disease in early stage and physiological tremor by tremor analysis

目的探讨震颤分析对早期帕金森病(PD)震颤和生理性震颤的鉴别。方法以14例PD患者(PD组)和9例生理性震颤者(生理性震颤组)为研究对象,将小加速器记录仪(Acc)电极贴附在手背中央掌骨末端处,同时将肌电图(EMG)表面电极置于前臂的伸肌和屈肌,分别在无负重和负重1000 g的条件下记录震颤图形和肌电活动30 s,并对震颤频率及与震颤相关的肌电活动进行统计分析。结果Acc检测显示:PD组主要表现为静止性震颤,震颤频率在有无负重条件下无明显改变;生理性震颤组主要为姿势或动作性震颤,负重条件下,震颤频率明显减低(P<0.01),震颤幅度有下降趋势。EMG显示:PD组可见与震颤相关的峰值肌电活动。结论Acc与EMG结合有助于临床鉴别早期PD震颤和生理性震颤。

Objective To explore the difference of the tremor of Parkinson＇s disease （PD） in early stage and physiological tremor by tremor analysis. Methods 14 patients with PD （group PD ） and 9 cases of physiological tremor （group physiological tremor） were studied. The surface electrode of the accelerometry （Ace） was pasted at the end of certer-metaearpal of back of hand. At the same time, surface electrodes of electromyography （EMG） were pasted on the forearm flexors and extensors. The tremor graphices and myoeleetric activities were recorded in 30 s with and without 1000 g bearing respectively. Tremor frequency and related myoeleetric activities were analysed. Results Aec record： The main manifestations were static tremor and tremor frequency was no significant difference when with and without loading in group PD. In group physiological tremor, the main manifestations were posture or active tremor. With loading ,the tremor frequency was significant reduced （P 〈 0. 01 ）and the tremor amplitude was reduced too. EMG record showed peak myoelectric activities related tremor in group PD. Conclusion It is helpful for clinical difference of the PD tremor in the early stage and physiological tremor when application Ace combined with EMG.