多系统萎缩非运动症候的临床研究

目的总结多系统萎缩(multiple system atrophy,MSA)以非运动症候和运动症候为首发症状的构成比和MSA非运动症候的具体症候构成比。方法选择MSA患者31例,其中MSA-P型18例,MSA-C型13例。进行详细病史记录和神经系统体检,记录运动症候及非运动症候具体表现及出现时间。结果 23例MSA以非运动症候首发。非运动症候的首发症状以快速眼动睡眠异常、排尿障碍、性功能障碍及直立性低血压常见。31例MSA患者均有非运动症候表现。以直肠功能障碍(93.5%)、排尿障碍(90.3%)、直立性低血压(64.5%)、睡眠呼吸暂停(61.3%)、快速眼动睡眠异常(48.4%)最为常见。MSA-P型与MSA-C型在年龄、性别、首发病程、就诊病程及非运动症候构成比较,差异无统计学意义(P>0.05)。结论 MSA患者普遍存在自主神经功能障碍等非运动症候表现,且以首发症状多见。MSA-C型患者中以非运动症候起病较MSA-P型患者更为多见。

Nonmotor syndrome in multiple system atrophy

Objective To summarize the constitutional ratio of multiple system atrophy(MSA)initially manifested as nonmotor or motor syndrome.Methods Thirty-one MSA patients were divided into MSA-P type group(n=18)and MSA-C type group(n=13).Their medical history,manifestations and their development time of motor or nonmotor symdrome were recorded.ResultsMSA was initially manifested as nonmotor syndrome in 23 MSA patients.Its common initial symptoms were rapid eyemovement sleep behavior disorder,urinary dysfunction,sexual disorder,and orthostatic hypotension.MSA was initially manifested as motor syndrome in 31 MSA patients.Its common initial symptoms were rectal dysfunction,urinary dysfunction,orthostatic hypotension,sleep apnea and rapid eyemovement sleep behaviour disorder,accounting for 93.5%,90.3%,64.5%,61.3%,and 48.4%respectively of its total symptoms.No significant difference was found in nonmotor syndrome and its morbidity between MSA-P type group and MSA-C type group(P>0.05).Conclusion MSA patients are usually manifested as nonmotor syndrome such as autonomic nervous dysfunction.Nonmotor syndrome is more commonly observed in MSA-C type patients than in MSA-P type patients.