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纯自主神经功能衰竭和多系统萎缩进展及预后的对比研究
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作者 mabuchi n. Hirayama M. +2 位作者 Koike Y. G. Sobue 李一明 《世界核心医学期刊文摘(神经病学分册)》 2005年第10期26-26,共1页
Objective: To clarify the progression of autonomic symptoms and functional de terioration in pure autonomic failure (PAF), particularly in comparison with mul tiple system atrophy (MSA). Methods: The investigation inv... Objective: To clarify the progression of autonomic symptoms and functional de terioration in pure autonomic failure (PAF), particularly in comparison with mul tiple system atrophy (MSA). Methods: The investigation involved eight patients w ith PAF (M/F=7/1; mean age at onset, 57 years) and 22 with probable MSA matched for age at onset (M/F=14/8; onset 56 years). Subjects were followed up for neuro logical symptoms, activities of daily living, and autonomic function for more th an seven years. Autonomic functional tests were carried out. Results: In PAF, fa inting or sudomotor dysfunction occurred first, followed by constipation and syn cope. Urinary dysfunction developed late, and respiratory dysfunction was not ev ident. This clinical course contrasted sharply with that in MSA, where early uri nary dysfunction usually proceeded to sudomotor dysfunction or orthostatic hypot ension (p=0.004), followed by respiratory dysfunction (p=0.0004). Results of pha rmacological tests also distinguished PAF from MSA. Progression and prognosis in patients with PAF did not worsen, unlike the steady progressive autonomic dysfu nction in MSA (p < 0.0001, p < 0.0001, p=0.0009, and p=0.003, for progression to modified Rankin scale grade III, IV, V, and death, respectively). Conclusions: The time course and pattern of progression of autonomic failure differed signifi cantly between PAF and MSA. Patients with PAF had slower functional deterioratio n and a better prognosis. 展开更多
关键词 多系统萎缩 泌尿功能障碍 呼吸功能障碍 发病年龄 神经症状 随访内容 自主功能 直立性低血压 时间过程 临床进展
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