多系统萎缩P型与早期帕金森病患者姿态平衡特点分析

摘要

目的 运用动态姿态平衡仪对多系统萎缩(MSA)-P型与早期帕金森病患者进行姿势定量测试分析,研究两者之间的异同.方法 分别选取病程不超过2年、H&Y分期不大于2.5的多系统萎缩P型与早期帕金森病患者共58例,根据诊断分为MSA-P组28例和PD组30例.运用动态姿态平衡仪对两组患者进行动态姿态平衡测试分析,测试内容包括感觉整合测试、稳定性极限评测、跌倒风险测试.比较两组测试结果.结果 MSA-P组感觉整合测试综合评分显著低于PD组(P＜0.05).2组稳定极限评测总面积差异无统计学意义(P＞0.05).跌倒风险评测中,MSA-P组睁、闭眼状态下平台平移测试的平衡恢复所需的能耗以及时间均大于PD组(P＜0.05).正弦摆动测试中,MSA-P组与PD组睁眼状态下前后、左右方向的增益对比,差异均有统计学意义(P＜0.05),但两组相位差对比,差异无统计学已有(P＞0.05);闭眼状态下,MSA-P组与PD组前后方向的增益以及相位差差异无统计学意义(P＞0.05),左右方向差异有统计学意义(P＜0.05).MSA-P组跌倒风险显著高于PD组(P＜0.05).结论 MSA-P型患者姿势平衡障碍明显重于早期帕金森病患者,通过动态平衡检查可以早期鉴别MSA-P型与PD患者.%Objective To investigate the differences between patients with early Parkinson disease and those with MSA-P by dynamic posture test.Methods 58 early stage Parkinson disease(ESPD) and MSA-P patients with course duration less than 2 years and Hoehn-Yahr stage less than 2.5 were recruited into this study.They were divided into an early stage Parkinson disease(ESPD) group (ESPD group,n=30) and an MSA-P (n=28) by diagnosis.Tests were performed to examine the difference in Dynamic posture balance between these two groups;these tests were Sensory Orgenisation Test,Limits of stability area,and Fall Assessment by using Dynamic posture balance instrument.Results The average composite scores of the MSA-P group for SOT were significantly higher than those of the ESPD group.(P＜0.05).There were no statistical differences (P＞0.05)in the average composite scores of limits of stability area between these two groups.Falling risk assessment showed that,in RAMP test section,the energy consumption and time required to restore balance in the MSA-P group were greater and longer than those in the ESPD group under all eye status (P＜0.05).In the SINUS test of our risk assessment with eyes open,there were statistical differences between the gains acquired from forward-backward movement and left-right movement for the MSA-P group and the ESPD group (P＞0.05);but there was no statistical difference in terms of phase difference (P＜0.05).On the other hands,with eyes closed,there were no statistical differences between the MSA-P group and the ESPD group in terms of both gains and phases difference acquired from forward-backward movement (P＜0.05);however,stadistical differences were shown in the left-right movement (P＜0.05).The falling risk of the MSA-P group was obviously higher than that of the ESPD group.Conclusions Dynamic posture disability is more severe in patients with MSA-P than those with early Parkinson disease.And dynamic posture test can help clinicians distinguish early Parkinson disease from MSA-P.