血管性帕金森综合征与帕金森病对比研究

目的探讨血管性帕金森综合征(VP)的临床及影像特点以及与帕金森病(PD)的区别。方法对50例VP及118例PD住院或长期门诊随访患者临床及影像学检查,进行归纳分析和统计学处理。结果VP发病年龄大于PD;多以肌僵直-少动起病;临床上以对称性铅管样肌僵直-少动为主,静止性震颤少见;可伴锥体束损害表现和智能障碍、尿失禁。VP影像学主要表现为基底节、脑室周围多发腔隙性梗死;而单纯PD无脑梗死改变。结论VP发病可能与长期高血压、腔隙性脑梗死有关;VP临床表现与PD存在不同;脑MRI或CT检查对两者鉴别具有重要意义。

Contrasting clinical analysis between vascular parkinsonism and idiopathic Parkinson' s disease

Objective To explore clinical difference of VP and PD.Methods Clinical manifestations and imagin g changes were retro-spectively investigated in hospita lized or long-time following-up patients with VP(n=50)and PD(n=118).Results Age at onset in VP patients was older than that in PD.Mo st of VP patients were accompanied by chronic hypertension(n=28,56%).VP was characterized clini-cally by frequent rigidity-bradyki nesia onset,symmetrical lead-pipe rigidity,and infrequent resting tr emor.Parts of VP demonstrated pyram idal tract damage sign,intellect diffic ulty and incontinence of urine.Howe ver,clinical features of patients with PD were revealed by usual resting tremor at onset,asymmetrical cog-w heel rigidity,frequent resting tre mor,and absence of pyramidal tract damage sign.Core imaging changes were multiple lacunar infarcts in basal g anglia and periventrical cerebral white matter.Conclusion VP is accompanied by hypertension.C linical features is different between VP and PD,and imaging changes in VP group are multiple lacunar infarcts in basal ganglia and periventrical cerebral white matter.