血管性帕金森综合征临床特点分析

Analysis of Clinical Features of Vascular Parkinsonism

目的探讨血管性帕金森综合征(VP)患者的临床特点。方法对50例VP患者的临床表现、影像学特点和治疗效果通过改良Hoehn-Yahr分期标准及简易智能状态检查量表(MMSE)进行观察和分析。结果 VP患者均有脑卒中史,既往有颈动脉粥样硬化、高血压、糖尿病病史;临床表现以偏瘫、少动为主,锥体束损害明显,静止性震颤少见,常伴有智能障碍等。颅脑MRI显示以基底核、脑室周围多发腔隙性脑梗死为主,多伴脑萎缩、白质疏松。改良Hoehn-Yahr分期及MMSE评价治疗前、治疗3周及3个月后比较,差异均无统计学意义(P>0.05)。VP患者治疗效果比较,差异无统计学意义(P>0.05)。结论左旋多巴制剂和多巴胺受体激动剂联合,并辅以脑血管病综合治疗措施,对VP患者的肌强直、少动和震颤症状有一定改善,是目前临床中最常用的治疗方法。

Objective To investigate the clinical features of patients with vascular parkinsonism （VP） . Methods Clinical manifestations, imaging features and therapeutic effect of 50 VP patients were observed and analyzed through modified Hoehn - Yahr Staging Scale and Mini Mental State Examination （MMSE） . Results All the VP patients have hypertension, dia- betes and stroke history, and their clinical manifestations were mainly paralysis, muscle rigidity and lack of exercise, as well as pyramidal tract damage and infrequent rest tremor, often accompanied by mental retardation. MRI showed multiple ischemic strokes in basal ganglia and periventricular area, accompanied by cerebral atrophy and leukoaraiosis. Modified Hoehn - Yahr Staging Scale and MMSE scores showed no statistically significant differences before treatment, three weeks after treatment and three months after treatment （ P 〉 O. 05 ）. No statistically significant difference showed in the therapeutic effect for the VP pa- tients （ P 〉 0. 05 ） . Conclusion The combination of levodopa preparations and dopamine receptor agonist assisted by compre- hensive treatment for cerebrovascular disease can improve muscle rigidity, lack of exercise and tremor symptoms in VP patients. It is one of the most frequently used methods in clinic.