摘要
目的 分析特发性震颤(essential tremor,ET)的临床特点。方法 对1997～2000年收治的42例特发性震颤患者发病年龄、性别、病程、震颤部位、震颤扩展方式、家族史、饮酒及药物反应等方面进行临床分析。结果 男女患者之比为28:1,平均发病年龄为(48.7±7.4)岁,呈单峰模式,病程(8.6±6.5)年。61.90％(26/42)的患者有家族史。42例患者中单纯姿势性震颤者30例(71.43％),运动性震颤者4例(9.52％),姿势及运动混合性震颤者2例(4.76％)。累及部位依次为双上肢者26例(61.90％),头部12例(28.57％),单侧上肢10例(23.81％),下颌2例(4.76％),舌2例(4.76％),发声肌1例(2.38％),躯干1例(2.38％)。36例参加饮酒试验者,29例(80.56％)有酒精反应;32例接受普萘洛尔治疗,完成治疗试验者28例(87.50％),服药后患者临床症状明显改善,与用药前比较差异有显著性意义(P<0.01)。结论 特发性震颤的临床表现以单症状姿势性震颤为主,上肢及头部受累明显,多数患者对酒精有反应,普萘洛尔治疗有效。
Objective The clinical characteristics of essential tremor (ET) were analyzed. Methods The age, sex, duration of tremor, family history of ET, tremor type, severity, distribution, reaction of alcohol and medicine in 42 patients with ET were recorded and analyzed. Results In these patients there were male:female 2.8:1, mean age of tremor onset (48.7±7.4) years, mean duration of disease (8.6±6.5) years, positive family history 61.90%, postural tremor 30 cases (71.43%), kinetic tremor 4 cases (9.52%) and both postural and kinetic tremor 2 cases (4.76%). Tremor affected both arms in 26 cases (61.90%), head 12 cases (28.57%), unilateral arm 10 cases (23.81%), chin 2 cases (4.76%), tongue 2 cases (4.76%), throat one case (2.38%), trunk one case (2.38%). There were 29 cases (80.56%) with alcohol sensitivity in 36 patients who had attended the alcohol test. Among the 32 patients received propranolol treatment, 28 patients (87.50%) completed the therapeutic test with significant difference (P<0.01) between pre- and post-treatment. Conclusion It is demonstrated that the main manisfestation of ET is postural tremor and obviously involved in head and arms.The effect of alcohol occurrs in most cases and propranolol treatment is effective.
