摘要
目的:总结帕金森病及运动障碍疾病门诊震颤患者的病因及临床表现,以提高门诊震颤患者的诊断率,降低误诊率,为门诊震颤诊断提供临床经验。方法:连续收集西京医院神经内科帕金森病及运动障碍疾病门诊自2015年5月至2016年7月收治的震颤患者进行横断面研究。采用SPSS19.0软件进行统计分析。结果:共纳入400例震颤患者,男性173例(43.3%),女性227例(56.8%),男女之比1:1.3,平均发病年龄54.0岁。40岁以下特发性震颤(ET)最多,41-60岁为帕金森病(PD),60岁以上帕金森病最多。震颤按临床表现形式分为静止性震颤85例(21.3%),动作性震颤137例(34.3%),混合性震颤178例(44.5%)。震颤按病因分类,占比例前三位的分别是:帕金森病(46.3%),特发性震颤(28.5%),心因性震颤(5.8%)。心因性震颤急性起病率及合并焦虑抑郁率最高,而PT画螺旋圈及书写阳性率明显低于其他病因组。结论:门诊震颤患者混合性震颤形式较多见,最常见病因为帕金森病、特发性震颤及心因性震颤;心因性震颤较其他病因所致震颤相比,急性起病率、合并焦虑抑郁率高,而画螺旋圈及书写阳性率低。震颤诊断应先明确震颤的临床特点,然后分析病因以确定诊断及治疗。
Objective：To investigate the clinical manifestation,classification,etiology of outpatient with service tremor,improve the diagnostic rate,reduce the misdiagnosis rate and provide experiences for the diagnosis of tremor for outpatient doctors.Methods：Patients with tremor enrolling in the Parkinson＇s Disease and Movement Disorder Disease Outpatient of the Department of Neurology in our hospital were collected continuously with Clustering sampling method from May 2015 to July 2016.Using SPSS19.0 software for statistical analysis.Results：400 patients with tremor,including 173 male cases（43.3%）,227 female cases（56.8%） were selected,the male to female ratio was 1：1.3,aged 14-87,the average age was 54.0 years old.ET is the most common in patients with 40 and below years,PD is the most common in the age group of 41-60 years and accounted for 53.0% in all PD patients;and PD is always the most common in the patients of 60 years and above years,According to the manifestations,tremor could be classified into rest tremor,85 cases（21.3%）,action tremor 137 cases（34.3%）,mixed tremor 178 cases（44.5%）.According to the manifestations and etiology,Parkinson＇s disease（46.3%）,Essential tremor（28.5%）,Psychogenic tremor（5.8%） were the most common three disease.There were 13 cases with acute onset of PT and accounted for 56.5% in all PT patients.Conclusions：According to the manifestations,the proportion of mixed tremor was highest.The most common three etiologies were Parkinson＇s disease,Essential tremor and Psychogenic tremor.Compared with tremor caused by other etiologies,PT has higher rate of acute onset and associated anxiety depression,and the proportion of positive with drawing spiral and writing was lower.We should firstly estimate clinical characteristics of tremor,then we should have further imaging so on to determine the diagnosis and treatment.
作者
李晓莉
管昭锐
龚阳
郭欣
张云
刘学东
LI Xiao-li;GUAN Zhao-rui;GONG Yang;GUO Xin;ZHANG Yun;LIU Xue-dong(Department of Neurology,Xi＇jing hospital,Fourth Military Medical University,Xi＇an,Shaanxi,710032,China;Department of Neurology,The secondpeople＇s hospital ofshaanxiprovince,Xi＇an,Shaanxi,710007,China)
出处
《现代生物医学进展》
CAS
2018年第18期3485-3489,3484,共6页
Progress in Modern Biomedicine
基金
陕西省科学技术研究发展计划项目(2011k14-07-02)
关键词
震颤
临床表现
病因
分类
Tremor
Clinical manifestation
Etiology
Classification
