Huang J B, Zhang Z X, Wu J X
Department of Neurology, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2001 Feb;23(1):19-22.
To study the Clinical characteristics of Parkinson's disease(PD) in natural population.
All the patients diagnosed as Parkinsonism from a prevalence study in Beijing in 1997 were collected for investigation. The spectrum of the clinical features of Parkinsonism and the onset, progression and prognosis of PD were analysed, as well as the impact factors to the prognosis were analysed.
109 cases were ascertained as PD from the sample population, in which 64(58.7%) were PD, 11 (10.1%) were Parkinson plus syndrome and 34(31.2%) were symptom Parkinsonism. 30 of the 64 PD cases were male. The median age of PD was 74.5 years. The median age at onset was 68 years old. The median duration was 5 years. The average Hoehn-Yahr staging score was 2.81. The clinical characteristics of PD and other Parkinsonism were compared, as asymmetry of symptoms and signs was an important feature to differentiate PD from other Parkinsonism. 20.3 percent of PD cases were associated with dementia. 16(25%) of the 64 PD cases initiated with essential tremor and developed to PD during 6-49 years after the onset of tremor. Tremor was the dominant initial symptoms of PD(60.9%). Type of initial symptoms was a relatively definite impact factor to the prognosis of PD. Levodopa treatment was likely to delay the duration of PD.
The clinical features of Parkinsonism in natural population were different as compared with previous studies. A further study on the natural history of PD thoroughly is needed.
研究自然人群中帕金森病(PD)的临床特征。
收集1997年在北京进行的一项患病率研究中所有被诊断为帕金森综合征的患者进行调查。分析帕金森综合征的临床特征谱、PD的起病、进展和预后,以及对预后的影响因素。
从样本人群中确诊109例PD,其中64例(58.7%)为PD,11例(10.1%)为帕金森叠加综合征,34例(31.2%)为症状性帕金森综合征。64例PD患者中30例为男性。PD的中位年龄为74.5岁。中位起病年龄为68岁。中位病程为5年。平均Hoehn-Yahr分期评分为2.81。比较了PD与其他帕金森综合征的临床特征,症状和体征的不对称是区分PD与其他帕金森综合征的重要特征。20.3%的PD患者伴有痴呆。64例PD患者中有16例(25%)以特发性震颤起病,在震颤起病后6 - 49年发展为PD。震颤是PD最主要的初始症状(60.9%)。初始症状类型是影响PD预后的一个相对明确的因素。左旋多巴治疗可能会延缓PD的病程。
自然人群中帕金森综合征的临床特征与以往研究不同。需要对PD的自然史进行更深入的研究。