原发性震颤患者的非运动症状  

Clinical study on non-motor symptoms of essential tremor

作　　者：张萍[1] 胡伟东[1] 毛成洁[1] 刘建芳[1] 陈菊萍[1] 刘春风[1] 

机构地区：[1]苏州大学附属第二医院神经内科,215004

出　　处：《中华神经科杂志》2010年第2期106-109,共4页Chinese Journal of Neurology

基　　金：苏州市“科教兴卫”青年科技基金资助项目（SWKQ0810）;苏州市科技发展计划（社会发展及医药）基金资助项目（SS0701）

摘　　要：目的 研究原发性震颤（essential tremor，ET）患者嗅觉障碍等非运动症状的发生情况。方法对62例ET患者应用震颤评分量表（Fahn-Tolosa-Marin Tremor Rating Scale，TRS）、帕金森病非运动症状30问卷量表（Parkinson’s disease non-motor symptoms questionnaire，NMSQuest）和MMSE进行评分，T＆T标准嗅觉测试液检测嗅觉功能，并与60名健康体检者进行对照。结果ET患者的嗅觉障碍发生率为51．6％（32／62），明显高于健康对照组（30．0％，18／60，χ2=12．371，P〈0．05）；平均每例ET患者出现5项左右不同的非运动症状，以对近期发生的事情记忆有困难或忘记做一些事情、嗅觉障碍、令人紧张或害怕的梦或生动梦境的发生率较高。嗅觉障碍等非运动症状的发生与ET患者的病程、病情严重程度、治疗与否没有明显的相关性。结论除姿势性震颤或动作性震颤外，ET患者还会出现嗅觉障碍等非运动症状，需要全面认识和及时干预。Objective To survey the prevalence, distribution of non-motor symptoms （NMS） in essential tremor （ET） and the relationship with disease severity and duration. Methods Fahn-Tolosa- Matin Tremor Rating Scale （TRS） was used to assess motor symptoms in 62 patients with ET. The Parkinson＇s disease （PD） NMS Questionnaire and T＆T olfacmcter and Mini-mental State Examination （MMSE） were used to explore non-motor symptoms in ET patients. Results In ET, a range of NMS occurred across all disease stages. More than half patients （ 51.6% , 32/62 ） had olfactory dysfunction, significantly higher than the healthy control group （30. 0%, 18/60, X2 = 12. 371, P 〈 0. 05 ）. A third had hyposmia. 16. 1% had partial olfactm＂y loss. Each ET patient had 5 different NMS on average. Seven NMS were more common in ET patients than in control,including remembering,olfactory dysfunction,intense vivid dreams, anhedonia, depression, anxiety, sleep disorders. The incidences of remembering, olfactory dysfunction, intense vivid dreams were 58. 1% （36/62） ,51.6% （32/62） ,48.4% （ 30/62）, ranked top 3 in ET patients. Olfaction had inverse correlation with age, while there was a negative correlation between NMS score and TRS score, gender, disease duration and weather to be treated. Conclusion Besides posture tremor and kinetic tremor, NMS occur in ET, and should be well recognized and treated.

关 键 词：特发性震颤 嗅觉障碍 抑郁 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R161[医药卫生—临床医学]