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华西医学  2011 

多系统萎缩患者的临床特点分析

, PP. 663-666

Keywords: 多系统萎缩,临床特点,诊断

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Abstract:

【】 目的 研究不同亚型多系统萎缩(multiplesystematrophy,MSA)患者的临床特点。 方法 回顾分析2009年1月―2011年1月收治的105例“很可能的”MSA患者的临床资料,包括发病年龄、首发症状、临床表现、治疗反应性等。 结果 105例MSA患者中,男57例,女48例,发病年龄58岁。以小脑性共济失调为主要特点的MSA(MSAwithpredominantcerebellarataxia,MSA-C)患者76例,以帕金森综合征为主要特点的多系统萎缩(MSAwithpredominantparkinsonism,MSA-P)患者29例。39例患者仅以小脑功能障碍为首发症状;29例患者仅以帕金森综合征为首发症状,23例患者仅以自主神经功能障碍为首发症状,其余14例患者的首发表现至少包括2种症状组合。至最后一次随访时,54例患者同时存在小脑功能障碍、帕金森综合征、自主神经功能障碍和锥体束征,51例患者表现为自主神经功能障碍与小脑功能障碍和(或)帕金森综合征的不同形式的组合。 结论 MSA患者以MSA-C为主。由于在病程早期,MSA与其他帕金森综合征或小脑性共济失调疾病的鉴别较为困难,因此,仔细动态观察患者临床特点的演变情况,对MSA的诊断至关重要。【Abstract】 Objective Toinvestigatesubtypesandclinicalfeaturesofmultiplesystematrophy(MSA). Methods Theclinicaldataof105probableMSApatientstreatedinourhospitalfromJanuary2009toJanuary2011wereanalyzed,includingtheageatonset,initialsymptoms,clinicalmanifestationsandresponsivitytolevodopa. Results The105probableMSApatientsconsistedof57malesand48females,including76patients(72.4%)ofMSAwithpredominantcerebellarataxia(MSA-C)and29patients(27.6%)ofMSAwithpredominantparkinsonism(MSA-P).Themeanageatonsetwas58years.Theinitialsymptomof39patientswaspurecerebellardysfunction.Twenty-ninepatientspresentedpureparkinsonismastheinitialsymptom.Theinitialsymptomof23patientswaspuredysautonomia.Bythelastclinicalvisit,54patientshadcerebellardysfunction,parkinsonism,autonomicfailureandpyramidalsigns. Conclusion ThestudyrevealedapredominanceofMSA-Cpatients.ThedifferentiationofMSAandotherformsofparkinsonismorcerebellarataxiamaybedifficultattheearlystage.Formoreaccuratediagnosis,itisimportanttocarefullyobservetheclinicalprogression.

References

[1]   Gilman S, Wenning GK, Low PA, et al. Second consensus statement on the diagnosis of multiple system atrophy[J]. Neurology, 2008, 71(9): 670-676.
[2]   Santens P, Crevits L, Van der Linden C. Raynaud’s phenomenon in a case of multiple system atrophy[J]. Mov Disord, 1996, 11(5): 586-588.
[3]   Jamora RD, Gupta A, Tan AK, et al. Clinical characteristics of patients with multiple system atrophy in Singapore[J]. Ann Acad Med Singapore, 2005, 34(9): 553-557.
[4]   Vanacore N, Bonifati V, Fabbrini G, et al. Epidemiology of multiple system atrophy. ESGAP Consortium. European Study Group on Atypical Parkinsonisms[J]. Neurol Sci, 2001, 22(1): 97-99.
[5]   李鑫, 石正洪, 李生泮, 等. 不同类型多系统萎缩临床表现与磁共振成像特征分析[J]. 中国全科医学, 2010, 13(14): 1548-1551.
[6]   何振巍, 张朝东. 多系统萎缩的临床诊断研究进展[J]. 中风与神经疾病杂志, 2010, 27(1): 83-85.
[7]   Geser F, Wenning GK, Seppi K, et al. Progression of multiple system atrophy (MSA): a prospective natural history study by the European MSA Study Group (EMSA SG)[J]. Mov Disord, 2006, 21(2): 179-186.
[8]   Papapetropoulos S, Tuchman A, Laufer D, et al. Causes of death in multiple system atrophy[J]. J Neurol Neurosurg Psychiatry, 2007, 78(3): 327-329.
[9]   Sakakibara R, Hattori T, Uchiyama T, et al. Urinary dysfunction and orthostatic hypotension in multiple system atrophy: which is the more common and earlier manifestation[J]. J Neurol Neurosurg Psychiatry, 2000, 68(1): 65-69.
[10]   Boesch SM, Wenning GK, Ransmayr G, et al. Dystonia in multiple system atrophy[J]. J Neurol Neurosurg Psychiatry, 2002, 72(3): 300-303.
[11]   Slawek J, Derejko M, Lass P, et al. Camptocormia or Pisa syndrome in multiple system atrophy[J]. Clin Neurol Neurosurg, 2006, 108(7): 699-704.
[12]   Geser F, Wenning GK. Disproportionate antecollis: a warning sign for multiple system atrophy[J]. Mov Disord, 2007, 22(13): 1986.
[13]   Hughes RG, Gibbin KP, Lowe J. Vocal fold abductor paralysis as a solitary and fatal manifestation of multiple system atrophy[J]. J Laryngol Otol, 1998, 112(2): 177-178.
[14]   Silber MH, Levine S. Stridor and death in multiple system atrophy[J]. Mov Disord, 2000, 15(4): 699-704.
[15]   Reich SG. The cold hands sign in MSA. Multiple system atrophy[J]. Neurology,2003, 60(4): 719.
[16]   Parvizi J, Joseph J, Press DZ, et al. Pathological laughter and crying in patients with multiple system atrophy-cerebellar type[J]. Mov Disord, 2007, 22(6): 798-803.
[17]   Shimohata T, Shinoda H, Nakayama H, et al. Daytime hypoxemia, sleep-disordered breathing, and laryngopharyngeal findings in multiple system atrophy[J]. Arch Neurol, 2007, 64(6): 856-861.
[18]   Wenning GK, Tison F, Ben-Shlomo Y, et al. Multiple system atrophy: a review of 203 pathologically proven cases[J]. Mov Disord, 1997, 12(2): 133-147.
[19]   Watanabe H, Saito Y, Terao S, et al. Progression and prognosis in multiple system atrophy: an analysis of 230 Japanese patients[J]. Brain, 2002, 125(Pt 5): 1070-1083.
[20]   Yabe I, Soma H, Takei A, et al. MSA-C is the predominant clinical phenotype of MSA in Japan: analysis of 142 patients with probable MSA[J]. J Neurol Sci, 2006, 249(2): 115-121.
[21]   Litvan I, Goetz CG, Jankovic J, et al. What is the accuracy of the clinical diagnosis of multiple system atrophy A clinicopathologic study[J]. Arch Neurol, 1997, 54(8): 937-944.

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