交感皮肤反应对帕金森病自主神经损害的诊断价值

Diagnostic value of sympathetic skin response for autonomic nerve damage in Parkinson's disease

目的探讨交感皮肤反应(SSR)对帕金森病(PD)患者自主神经损害的诊断价值。方法选择62例PD患者(PD组)和26例年龄、性别、身高相匹配的健康志愿者(健康对照组)进行上下肢SSR检测。将PD组根据有无自主神经症状分为有症状组和无症状组;根据Hoehn-Yahr分级将PD组分为早期PD组(1～2期)和中晚期PD组(3～5期)。结果①与健康对照组比较,PD无论有症状组还是无症状组SSR潜伏期延长和波幅下降(均P<0.05);有症状组较无症状组潜伏期延长和波幅下降(均P<0.05);②与健康对照组比较,不论中晚期PD组还是早期PD组SSR潜伏期延长和波幅下降(均P<0.05),中晚期PD组较早期PD组潜伏期显著延长和波幅下降(均P<0.05);③SSR上下肢潜伏期与Hoehn-YaHr分级呈显著性正相关(P<0.01),SSR上下肢波幅与Hoehn-YaHr分级呈显著性负相关(P<0.01)。结论①SSR是检测PD患者自主神经功能障碍的客观敏感手段,可发现亚临床自主神经损害,有助于早期诊断;②PD患者运动系统障碍越重,出现自主神经病变的程度越重。

Objective To investigate the diagnostic value of sympathetic skin response( SSR) for autonomic nerve damage in patients with Parkinson's disease( PD). Method The SSR measurement was performed in 62 PD patients( PD group) and 26 healthy volunteers( healthy control group) matched in age, sex and length.The PD group was divided into symptomatic group and asymptomatic group according to the symptoms of autonomic nerve. According to Hoehn-Yahr classification, PD group was divided into early PD group( stage 1-2) and middle late PD group( stage 3-5). Results ① Compared with the healthy control group, the latency and amplitude of SSR were prolonged and decreased in both symptomatic and asymptomatic PD groups( P<0.05);the latency and amplitude of SSR were prolonged and decreased in symptomatic group compared with asymptomatic group( P<0.05);②Compared with healthy control group, the latency and amplitude of SSR were significantly prolonged and decreased in both late and early PD groups( P<0.05);③There was a significant positive correlation between SSR latency and Hoehn-YaHr classification( P<0.01), and there is a significant negative correlation between SSR amplitude and Hoehn-YaHr classification( P<0.01). Conclusion ① SSR is an objective and sensitive method to detect autonomic nervous dysfunction in PD patients, and can detect subclinical autonomic nervous impairment and is helpful for early diagnosis;② The more severe the movement systerm disorders of PD patients, the more severe the degree of autonomic neuropathy.