Hershey L A, Feldman B J, Kim K Y, Commichau C, Lichter D G
Department of Neurology, Department of Veterans Affairs Medical Center, Buffalo, NY.
Arch Neurol. 1991 Oct;48(10):1049-51. doi: 10.1001/archneur.1991.00530220069021.
We examined 46 male patients with idiopathic Parkinson's disease to see whether tremor at onset was as useful a predictor of benign clinical outcome as tremor predominance after several years. When we compared patients with tremor at onset (n = 27) with those whose disease began with brady-kinesia/rigidity (n = 9), or gait disorder (n = 10), we found no significant differences after a mean of 7 years in motor, cognitive, or affective status. Sixteen of the tremor-onset patients continued to have tremor predominance with minimal gait disorder after about 7 years. These tremor-predominant patients had significantly better motor outcome and somewhat better cognitive outcome than either tremor-onset patients who subsequently developed gait disorder (n = 11) or patients without tremor at onset (n = 19). Tremor predominance after several years appears to be a better predictor of a benign clinical course of Parkinson's disease than tremor at onset.
我们对46名特发性帕金森病男性患者进行了研究，以确定疾病起病时的震颤是否与数年后以震颤为主一样，是良性临床结局的有效预测指标。当我们将起病时伴有震颤的患者（n = 27）与以运动迟缓/强直起病的患者（n = 9）或步态障碍起病的患者（n = 10）进行比较时，发现在平均7年后，他们在运动、认知或情感状态方面没有显著差异。约7年后，16名起病时伴有震颤的患者仍以震颤为主，步态障碍轻微。与随后出现步态障碍的起病时伴有震颤的患者（n = 11）或起病时无震颤的患者（n = 19）相比，这些以震颤为主的患者运动结局明显更好，认知结局也稍好。数年后以震颤为主似乎比起病时的震颤更能预测帕金森病的良性临床病程。
