震颤分析在原发性震颤与帕金森病鉴别诊断中的准确性及价值

Tremor analysis in differential diagnosis of essential tremor and Parkinson’s disease

目的探讨震颤分析对原发性震颤与帕金森病的鉴别诊断准确性及其应用价值。方法将2018年1月至2021年1月就诊的88例肢体震颤患者纳入研究,对患者实施震颤分析、中脑超声检查,以临床综合检查结果为参照,比较震颤分析、中脑超声检查对帕金森病、原发性震颤的诊断效能。结果88例单侧肢体震颤患者中,经临床综合诊断确诊47例帕金森病,30例原发性震颤,其余11例非原发性震颤、非帕金森病。震颤分析对帕金森病的诊断特异度、准确率、阳性预测值,及对原发性震颤的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值均高于中脑超声检查(P<0.05,P<0.01)。经一致性检验,震颤分析与临床综合检查结果之间的一致性达到高度。帕金森病患者的震颤频率均低于原发性震颤患者(P<0.01),且其震颤交替收缩比例均高于原发性震颤患者(P<0.01)。结论震颤分析可对帕金森病与原发性震颤进行准确的鉴别诊断,具有良好的诊断价值。

Objective To explore the accuracy and value of tremor analysis in differential diagnosis of essential tremor and Parkinson's disease.Methods Eighty-eight patients with limb tremor treated from January 2018 to January 2021 were selected for tremor analysis and midbrain sonography.Based upon the results of comprehensive clinical examination,the diagnostic efficacy of tremor analysis and midbrain sonography were compared in diagnosing essential tremor and Parkinson's disease.Results Among 88 patients with unilateral limb tremor,there were 47 cases of Parkinson's disease,30 cases of primary tremor and 11 cases of non-primary tremor and non-Parkinson's disease confirmed by clinical comprehensive diagnosis.The specificity,accuracy and positive predictive value by tremor analysis in the diagnosis of Parkinson's disease,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value by tremor analysis in the diagnosis of essential tremor were higher than those by midbrain ultrasonography(P<0.05,P<0.01).The consistency test showed the higher consistency between tremor analysis and clinical comprehensive examination.The tremor frequency of patients with Parkinson's disease was lower than that of patients with essential tremor(P<0.01),and the proportion of tremor alternating contraction was higher than that of patients with essential tremor(P<0.01).Conclusion Tremor analysis can accurately differentiate Parkinson's disease from essential tremor,and has good diagnostic value.