原发性震颤合并帕金森病与单纯帕金森病或单纯原发性震颤的震颤特征对比分析  

Comparative analysis of tremor characteristics between essential tremor with Parkinson disease and pure Parkinson's disease or pure essential tremor

作　　者：吴林[1] 孔凡斌[1] 杨芳[1] Wu Lin;Kong Fanbin;Yang Fang(Department of Neurology,Rizhao People's Hospital of Shandong Province,Shandong Rizhao 276800,China)

机构地区：[1]山东省日照市人民医院神经内科,276800

出　　处：《中国医师进修杂志》2020年第11期1026-1030,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:对比分析原发性震颤(ET)合并帕金森病(PD)与单纯PD或单纯ET的震颤特征。方法:选择2015年1月至2019年6月山东省日照市人民医院收治的ET合并PD患者35例(观察组)、单纯PD患者35例(对照Ⅰ组)以及单纯ET患者35例(对照Ⅱ组),对各组实施震颤分析检测并对结果进行统计学比较。结果:对照Ⅰ组、对照Ⅱ组、观察组间的静止性震颤、姿势性震颤比例以及震颤再出现时间[80.0%(28/35)比20.0%(7/35)和65.7%(23/35)、65.7%(23/35)比100.0%(35/35)和88.6%(31/35)、(10.2±2.6)s比(2.5±1.3)s和(7.6±2.9)s]比较差异均有统计学意义(P<0.05),对照Ⅰ组、对照Ⅱ组、观察组静止状态的震颤频率分别为(5.5±0.7)、(7.2±1.3)、(6.2±1.1)Hz,而姿势状态的震颤频率分别为(6.2±2.0)、(8.3±1.9)、(6.5±1.3)Hz,差异均有统计学意义(F=6.881、7.984,P<0.05),对照Ⅰ组、对照Ⅱ组、观察组静止状态出现交替收缩(主动肌与拮抗肌)比例分别为76.7%(23/30)、0、34.6%(9/26),姿势状态出现交替收缩比例分别为53.3%(16/30)、20.0%(7/35)、26.9%(7/26),差异均有统计学意义(χ^2=16.186、7.650,P<0.05),观察组上述各数据均居中。结论:ET合并PD兼具单纯PD或单纯ET的震颤特点又具有独特性,震颤分析能客观识别出ET合并PD的静止状态肌电图或交替放电情况。Objective:To compare and analyze the tremor characteristics between essential tremor(ET)with Parkinson disease(PD)and pure PD or pure ET.Methods:From January 2015 to June 2019 in Rizhao People′s Hospital of Shandong Province,35 patients with PD and ET(observation group),35 patients with pure PD(control groupⅠ)and 35 patients with pure ET(control groupⅡ)were selected.Tremor analysis were performed in all the patients,and the results of tremor analysis were compared statistically.Results:There were significant differences in the proportion of static tremor,postural tremor and the recurrence time of tremor among control group Ⅰ,control group Ⅱ and observation group:80.0%(28/35)vs.20.0%(7/35)and 65.7%(23/35),65.7%(23/35)vs.100.0%(35/35)and 88.6%(31/35),(10.2±2.6)s vs.(2.5±1.3)s and(7.6±2.9)s(P<0.05).The tremor frequencies of control groupⅠ,control groupⅡand observation group at rest were(5.5±0.7),(7.2±1.3)and(6.2±1.1)Hz,and at posture were(6.2±2.0),(8.3±1.9)and(6.5±1.3)Hz,respectively,with statistically significant differences among the three groups(F=6.881 and 7.984,P<0.05).The proportion of electromyography alternating contractions of the active and antagonistic muscles of control groupⅠ,control groupⅡand observation group at rest were 76.7%(23/30),0,34.6%(9/26),and at posture were 53.3%(16/30),20.0%(7/35),26.9%(7/26),with statistically significant differences among the three groups(χ2=16.186 and 7.650,P<0.05).The above data of the observation group were in the middle level.The working characteristic curve was used to analyze the efficacy of PD with ET,PD and ET,and the area under the curve was 0.654,0.756 and 0.771,respectively.Conclusions:ET with PD has both the characteristics of pure PD or pure ET and the unique characteristics.Tremor analysis can objectively identify the electromyography alternating contractions at rest of PD with ET.

关 键 词：帕金森病 特发性震颤 震颤分析 肌电图 

分 类 号：R742.5[医药卫生—神经病学与精神病学]