145例原发性震颤患者的临床特征分析
Clinical features of essential tremor in 145 patients

摘要：目的 总结分析原发性震颤(essential tremor, ET)患者的临床特点，并为该病的临床诊断及鉴别提供依据。方法 连续纳入2010年7月～2013年2月于西安交通大学第一附属医院门诊就诊及住院的ET患者，详细记录患者的一般情况及震颤特点、震颤分级及评分。结果 纳入145例患者，发病高峰40～50岁，男女比例相当。上肢震颤最为常见(88.96%)，其后依次为头部(39.31%)、下肢(13.10%)、下颌及舌(10.34%)，躯干部震颤最少见(2.76%)。震颤类型以单纯姿势性为主(63.44%)，其次为混合性(35.17%)，极少数为单纯运动性震颤(1.39%)。上肢震颤为首发者易出现波及伴有其他部位的震颤发生，发病年龄晚的患者震颤的进展速度较发病早的患者快。比较家族性与散发性ET患者的临床特点未发现明显不同。结论 ET的起病部位及发病年龄影响疾病的发展，遗传因素在ET的发病机制中可能并非主要因素。
ABSTRACT: Objective To summarize the clinical features of essential tremor (ET) so as to provide evidence for both its clinical and differential diagnosis. Methods All patients with definite ET from the First Affiliated Hospital of Xi’an Jiaotong University from July 2010 to February 2013 were enrolled in the study. We collected all their information including general condition, tremor type, tremor scale and tremor grade. Results There were 145 ET patients enrolled in this study. The single peak of onset age was between the forties and fifties, with male and female ones having the same prevalence. Tremor was the most common in upper limbs (88.96%), followed by head (39.31%), lower limbs (13.10%), jaw and tongue (10.34%), and trunk (2.76%). Tremor type was mainly isolated postural tremor (63.44%), followed by mixed type (35.17%) and isolated action tremor (1.39%). Those patients with upper limbs tremor experienced much more possibility of tremor spreading to other sites. And those with older age of onset showed more rapid progression. There was no difference in clinic features between familial ET and sporadic ET. Conclusion The onset anatomic distribution and age are related to the progression of ET. Genetic factor may not be the primary factor in the etiology of ET