目的 探讨帕金森病和多系统萎缩患者交感神经皮肤反应电位所显示的自主神经功能障碍的差异性,以为二者鉴别诊断提供临床依据.方法 采用MEB-9200K型肌电诱发电位仪分别对受试者进行交感神经皮肤反应电位检测,以波形潜伏期＞(x-+2.50)s、波幅低于均值的50%或未引出波形作为异常标准,分析帕金森病与多系统萎缩患者交感神经皮肤反应电位异常特征和病程等之间的相关性.结果 与正常对照组受试者相比,帕金森病组和多系统萎缩组患者交感神经皮肤反应电位检测显示四肢潜伏期延长、波幅降低(P＜0.05),但帕金森病组与多系统萎缩组之间差异无统计学意义(均P＞0.05);其中多系统萎缩组交感神经皮肤反虚电位总异常率(P=0.018)和双侧异常率(P＝0.035)均高于帕金森病组.帕金森病组病程≤3年者交感神经皮肤反应电位异常率与病程＞3年者比较,差异具有统计学意义(P=0.033);多系统萎缩组病程≤3年患者交感神经皮肤反应电位异常率与病程＞3年者比较,差异无统计学意义(P=0.285).结论 多系统萎缩患者交感神经皮肤反应电位异常出现早,且多呈双侧改变,表明其自主神经功能障碍更严重、更广泛.%Objective To observe the sympathetic skin responses (SSR) in idiopathic Parkinson's disease (PD) and multiple system atrophy (MSA) patients, and to explore the differences of autonomic dysfunction between them. Methods The SSR of PD patients, MSA patients and control cases were detected by MEB-9200K electromyogram (EMG), and data were compared. The waveform latency period > (i + 2.50) s, amplitude lower than 50% of the average or no elicited waveform were considered to be abnormal. The correlation of abnormal character of SSR and duration in PD and MSA patients were analyzed. Results The latency of SSR was prolonged and the amplitude was reduced in both PD and MSA patients, which were significantly different from that in control cases (P < 0.05). There was no significant difference of latency and amplitude between PD and MSA patients (P > 0.05, for all). The abnormal ratio of SSR (P = 0.018) and the abnormal ratio of double side (P = 0.035) in MSA patients was higher than that in PD patients. The abnormal ratio of SSR in PD patients with duration less than 3 years was significantly higher than cases with more than 3 years (P = 0.033). No significant difference of the abnormal ratio of SSR was seen between MSA patients with duration less than 3 years and more than 3 years (P = 0.285). Conclusion The early presence and bilateral changes of SSR are often seen in MSA patients, and the more severe and widespread autonomic dysfunctions are also found in MSA.
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