帕金森病震颤和原发性震颤的电生理学特征研究

摘要

Objective To explore the electrophysiological differences between Parkinson ' s disease tremor (PT ) and essential tremor (ET) .Methods Fifty PT patients and 70 ET patients and 45 age-gender-matched healthy volunteers admitted in Department of Neurology ,the Second Affiliated Hospital of Zhejiang University School of Medicine from May 2015 to April 2016 were included .Clinical data and tremor analyses under different postures were obtained .All patients were evaluated with tremor scores and accelerometry in resting ,postural and loading states .The amplitude ,frequency and frequency dispersion of rest tremor , postural tremor and the influence of weight on tremor were retrospectively analyzed and compared .Results The amplitude:Both PT amplitudes and ET amplitudes in loading states were higher than those in rest state (P<0.05) ,healthy volunteers'amplitudes in loading states were similar to those in rest state .The frequencies of all patients in loading states were faster than those in rest state ,and there were statistically significant differences in control group ,but there were not statistically significant differences in PD group and ET group .Conclusion We found that the tremor parameters measured by the accelerometry can not be used to dis-tinguish PD and ET patients ,but can be used to distinguish pathological tremor and physiological tremor .%目的 探讨帕金森病(Parkinson's disease,PD)震颤和原发性震颤(essential tremor,ET)患者电生理上的异同,为PD和ET的诊断提供思路.方法 选取2015-05—2016-04在浙江大学附属第二医院门诊就诊的50例PD患者(PD组),70例E T患者(E T组),以及45例年龄、性别匹配的健康志愿者(生理性震颤组),完善PD以及E T患者的震颤评分,通过加速度传感器对所有受试者进行3种姿势状态下的震颤分析检査.比较受试者的震颤幅度、震颤频率、震颤频谱宽度以及负重对其影响,总结2组患者的电生理学特点.结果 3组平均震颤幅度静止状态同负重状态比较,生理性震颤组变化不大,而PD和E T患者静止状态震颤幅度较负重状态明显减少,差异有统计学意义(P<0.05);震颤峰值频率比较:3组静止状态震颤频率均高于负重状态,健康对照组下降明显,差异有统计学意义(P<0.05),PD组和ET组差异无统计学意义(P>0.05).结论 PD震颤和ET震颤参数接近,加速度传感器测定的震颤参数难以区分二者,但对于生理性震颤和病理性震颤的鉴别存在一定的意义.