多系统萎缩临床特征分析

Analysis of Clinical Features of Multiple System Atrophy

目的通过对多系统萎缩的典型病例分析及文献复习加深对MSA的理解,提高早期诊断水平。方法对53例符合MSA临床诊断标准的病人,回顾分析其临床特片、肛门括约肌电图和MRI表现,并复习文献。结果20例MSA-C和33例MSA-P撮早期症状是排尿障碍或男性勃起障碍,18例有体位性低血压,MSA-C的主要运动症状是姿势型共济失调,MSA-P的主要运动症状是强直和运动困难,37例记录到肛门括约肌电图失神经改变。结论临床症状和体征的甄别,自主神经症状的发现和识别是准确诊断的的关键,电生理和MRI检查能为诊断提供启示。

Objective To deepen the understanding of MSA and improve its clinical diagnosis by analysis of the typical cases and literature review. Methods For the 53 cases which accord with the clinical diagnostic criteria of MSA, we review the clinical fea-tures, MMG and pertinent literature. Results Twenty of the 53 cases is MSA-C, and the other twenty-three are MSA-P. The earli-est symptoms are urinary dysfunction or male erectile disorder, 18 cases shows posturalhypotension. The motor symptoms of MSA-C is posture ataxia and MSA-P are tetany and dyskinesia. 48 cases showed positive bilateral pathologic sign and Anal sphincter electromyography neurogenic change. Conclusion The key of how to diagnosis correctly are discriminating the clinical symptoms and sign, and discovering and distinguishing the vegetative nervous symptoms, and combining with Electrophysiology and MRl can bring enlightenment to the diagnosis.