多系统萎缩临床特征分析

Clinical analysis of multiple system atrophy

目的 分析多系统萎缩（MSA）的临床特征.方法 回顾性分析解放军总医院神经内科2008年1月至2011年7月收治的78例临床诊断为MSA患者的人口学资料、临床表现、头颅MRI及肛门括约肌肌电图的临床资料及治疗措施.结果 MSA患者男性（45例）多于女性（33例）,男女比例为1.36∶1,中年起病,平均发病年龄（59±10）岁；MSA-C亚型多见,58例,占74.4％；58例（85.3％,58/68）患者头MRI显示阳性结果；34例（82.9％,34/41）患者肛门括约肌肌电图有神经源性损害.结论 MSA是一种累及神经系统多部位的变性疾病,首发症状以小脑症状最多,多数患者出现3个以上系统同时受累.MRI表现多以橄榄、桥脑、小脑萎缩为主,对MSA诊断有肯定意义.肛门括约肌肌电图有助于MSA的早期诊断.

Objective To analyze the clinical features of multiple system atrophy （MSA）. Methods The clinical data of 78 MSA cases were retrospectively analyzed from General Hospital of Chinese People＇s Liberation Army. Results The incidence was higher in males（45 cases） than that in females（33 cases）. The average age was （59 ＋ 10）years. The main type was MSA-C. MRI was midlife result in 58 cases （85.3%）. Thirty-four cases （82. 9% ） had neurodegenerative damage in extern anal sphincter electromyography （EAS- EMG）. Conclusion MSA is a metamorphic disease affecting multi-system. The primarily symptom is cerebeliar symptom. The second symptom is the autonomic dysfunction. More of three systems are involved in most cases. Olivopontocerebellar atro-phy in the MRI is common and can provide certain diagnostic evidences. EAS-EMG is helpful in the diagnosis of MSA.