手运动功能的定量检测对帕金森病诊断及鉴别诊断的意义

Examination of arm repetitive sequential movements in Parkinson disease

目的分析检测运动功能的电脑软件及装置对帕金森病诊断的敏感性和特异性。方法实验对象共分为三组,包括帕金森病组70例,特发性震颤组25例,健康对照组30例。应用设计的电脑软件,运用手指轮替试验和水平移动试验运动时间来定量检测受试者的手运动功能。结果帕金森病患者的水平移动平均运动时间和手指轮替平均运动时间比健康对照组明显延长(P<0.05)。帕金森病组手运动功能较特发性震颤组有明显的减退(P<0.05)。特发性震颤组与健康对照组相比两者手运动功能检测之间差异无显著性(P>0.05)。将单侧肢体移动平均运动时间、轮替运动平均运动时间联合分析,可使运动功能检测的敏感度和特异度分别达到非优势手80.00%和95.00%;优势手90.00%和95.24%。结论手运动功能测定装置是针对帕金森病患者手运动功能改变的有效检测方法,对帕金森病诊断有较高的敏感性和特异性。

Objective To design computer software and test its application of measuring repetitive sequential movements（RSM） of both arm and fingers. The sensitivity and specificity in RSM is analyzed. Method Subjects include 70 idiopathic Parkinson disease（PD） patients, 30 healthy controls and 25 essential tremor（ET） patients. The motor dysfunction is detected in the average locomotion velocity with finger knocking on keyboard. Result There is a deteriorating effect along with the prolonged repetitive testing in PD but not in the normal or ET patients（P〈0.05）. There is no difference in RSM between normal controls and ET（P〉0.05）. The sensitivity and specificity in RSM are 80.00%, 90.00% and 95.00%, 95.24% respectively by combining two index. Conclusion The device designed can be used to quantitatively and sensitively test the motor dysfunction of arm in PD, and can be of great value in the early diagnosis.