摘要
描述自然人群中的帕金森病（ Parkinson′ s disease, PD）的临床特征。方法采用北京市 1997年帕金森病患病率研究中获得的全部帕金森症（ Parkinsonism)病例作为研究对象，分析帕金森症的疾病谱、 PD的发病、进展、临床特征、预后以及影响预后的因素。结果 109例帕金森症中 PD 64例（ 58.7％），帕金森叠加综合征 11例（ 10.1％），症状性帕金森综合征 34例 (31.2％ )。 64例 PD患者中男 30例，女 34例，年龄中位数为 74.5岁，发病年龄中位数为 68岁，病程中位数为 5年，平均改良 H- Y分级为 2.81级。症状或体征的不对称性是鉴别 PD与其它帕金森症的重要临床特征。 20.3％的 PD病例合并有不同原因的痴呆。 25％的 PD患者在良性震颤的基础上 6～ 49年后出现典型的 PD症状。 PD的首发症状以震颤为主（ 60.9％） ,首发症状为强直少动型的患者病情进展相对较快，预后较差。左旋多巴治疗可能具有延长 PD病程的作用。结论自然人群中 PD的临床特征与以往对医院就诊人群的研究结果有显著的不同，有必要对帕金森病的自然史进行深入研究。
Objective To study the Clinical characteristics of Parkinson′ s disease(PD) in natural population. Methods All the patients diagnosed as Parkinsonism from a prevalence study in Beijing in 1997 were collected for investigation.The spectrum of the clinical features of Parkinsonism and the onset， progression and prognosis of PD were analysed， as well as the impact factors to the prognosis were analysed. Results 109 cases were ascertained as PD from the sample population, in which 64(58.7％ )were PD, 11(10.1％ ) were Parkinson plus syndrome and 34(31.2％ ) were symptom Parkinsonism.30 of the 64 PD cases were male. The median age of PD was 74.5 years. The median age at onset was 68 years old. The median duration was 5 years. The average Hoehn- Yahr staging score was 2.81.The clinical characteristics of PD and other Parkinsonism were compared, as asymmetry of symptoms and signs was an important feature to differentiate PD from other Parkinsonism. 20.3 percent of PD cases were associated with dementia. 16(25％ )of the 64 PD cases initiated with essential tremor and developed to PD during 6～ 49 years after the onset of tremor. Tremor was the dominant initial symptoms of PD（ 60.9％） . Type of initial symptoms was a relatively definite impact factor to the prognosis of PD. Levodopa treatment was likely to delay the duration of PD. Conclusions The clinical features of Parkinsonism in natural population were different as compared with previous studies. A further study on the natural history of PD thoroughly is needed.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2001年第1期19-22,共4页
Acta Academiae Medicinae Sinicae
基金
国家"九五"科技攻关项目!(96- 906- 05- 01)资助&&
