自主神经功能障碍型多系统萎缩临床诊断及治疗  

Clinical Diagnosis and Treatment in Patients of Autonomic Dysfunction WithMultiple System Atrophy

作　　者：杨虹[1] 曾昆[1] 魏桂荣[2] 李红戈[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院急诊科,湖北省武汉市430034 [2]华中科技大学同济医学院附属协和医院神经科

出　　处：《中国循环杂志》2011年第5期367-369,共3页Chinese Circulation Journal

摘　　要：目的:通过对自主神经功能障碍型多系统萎缩(Shy-Drager综合征,SDS)的临床和影像学特征、治疗方法和预后的研究,从而探讨SDS的早期诊断和治疗。方法:采用回顾性分析方法,收集我院神经科2005-06至2010-07诊断为SDS患者37例,男性22例(59.5%),女性15例(40.5%)。对37例SDS的特点及其他临床和影像学特征进行综合分析,尤其是直立性低血压的血压变化和伴发症状。结果:37例SDS患者临床以直立性低血压(30例,81.1%)、头昏或晕厥(29例,78.4%)、睡眠呼吸暂停综合征(28例,75.7%)常见。头颅计算机断层摄影术(27例,73.0%)和核磁共振成像(29例,78.4%)异常阳性率高。经药物等治疗均有不同程度改善。发病后4年无1例死亡,5年3例死于睡眠呼吸暂停综合征,2例死于肺部感染所致呼吸衰竭。结论:SDS临床以自主神经功能障碍为主要表现,早期诊断和针对性的治疗能够降低患者死亡率、提高生存时间和生活质量。Objective：To study the clinical features,imaging characteristics and prognosis in patients of autonomic dysfunction with mul- tiple system atrophy（ Shy-drager syndrome）in order to improve the early diagnosis and treatment of this disease. Methods：We retrospectively summarized 37 patients with Shy-drager syndrome who were treated in our hospital from June 2005 to July 2010 including 22 male（59. 5% ） and 15 female（40.5% ）. We especially analyzed the patients of multiple system atrophy with orthostatic hypotension and its concomitant symptoms. Results： There were 30 （ 81.8 % ） cases with orthostatic hypotension, 29 （78.4%） with dizzy or syncope, 28 （ 75.7 % ） with obstructive sleep apnea syndrome. There were 27 （ 73.0% ） cases with abnormal brain CT, and 29 （ 78.4% ） with abnormal brain MRI. All patients had improved condition with medication. There was no death within 4 years of onset,3 patients died in 5＇h year of obstructive sleep apnea syndrome and 2 died by respiratory failure. Conclusion ： Shy-drager syndrome had the main manifestation of autonomic dysfunction, early diagnosis with the corresponding treatment could decrease the mortality and improve the life quality in those patients.

关 键 词：Shy—Drager综合征 直立性低血压 

分 类 号：R541[医药卫生—心血管疾病]