静态平衡功能定量分析鉴别P型和C型多系统萎缩

发布时间：2018-10-22 09:56

【摘要】：目的对多系统萎缩帕金森(MSA-P)型与多系统萎缩共济失调(MSA-C)型患者进行静态平衡功能定量分析,比较两者的差异。方法分别选取MSA-P患者29例,MSA-C患者40例,同时纳入同龄正常人23例作为对照,利用SYNAPSYS姿势平衡仪对3组进行静态姿势平衡分析。在睁眼/闭眼、平板/软垫两种测试因素4种测试环境下监测重心偏移,力学数据经过傅里叶转换为能量值。比较3组感觉统合测试各项得分,跌倒和姿势性震颤的发生率,以及在检测中消耗能量的差异。结果与对照组比较,MSA组体感、视觉、前庭觉得分及总分均明显减少(P0.01)。与MSA-P组相比,MSA-C组前庭觉得分更低,差异有统计学意义(P0.05)。与对照组比较,MSA组在闭眼软垫测试中跌倒次数明显增多,且MSA-C组跌倒次数明显多于MSA-P组(P0.05)。特征性的3 Hz姿势性震颤在97.5%MSA-C患者中出现,在24.1%的MSA-P患者中出现,在正常人中从不出现。在各项测试环境下,3组间3 Hz姿势性震颤的出现率均不同,两两比较差异均有统计学意义(P0.05)。与对照组比较,MSA患者在各个方向、各个测试环境、各个能量频段所消耗的能量都明显增多,差异有统计学意义(P0.01)。MSA-P组和MSA-C组的能量分布差异主要表现在各个测试环境中的高频段(2~20 Hz)。随着测试难度增加,MSA-C组在各个频段耗能均明显高于MSA-P组(P0.05)。结论在静态平衡测试中MSAC和MSA-P均表现出严重的姿势平衡障碍,但在绝大多数MSA-C中可见典型的姿势性震颤,借助后者可对MSA进行准确分型。
[Abstract]:Objective to analyze the static balance function of patients with multiple system atrophy (MSA-P) and multiple system ataxia (MSA-C). Methods 29 patients with MSA-P, 40 patients with MSA-C and 23 normal subjects of the same age were included as control group. The static posture balance was analyzed by SYNAPSYS postural balance instrument. The shift of gravity center was monitored in four test environments: open eyes / closed eyes, flat plate / soft pad test factors, and the mechanical data were converted to energy value by Fourier transform. The scores of sensory integration test, the incidence of tumble and postural tremor, and the difference of energy consumption in the three groups were compared. Results compared with the control group, the somatosensory, visual, vestibular and total scores of MSA group were significantly decreased (P0.01). Compared with MSA-P group, the vestibular score of MSA-C group was lower, the difference was statistically significant (P0.05). Compared with the control group, the number of falls in the MSA group was significantly higher than that in the MSA-P group in the closed eye cushion test, and the number of falls in the MSA-C group was significantly higher than that in the MSA-P group (P0.05). Characteristic 3 Hz postural tremors were found in 97.5%MSA-C patients, 24. 1% of MSA-P patients, and never in normal subjects. In each test environment, the occurrence rate of 3 Hz postural tremor was different among the three groups, and the differences were statistically significant (P0.05). Compared with the control group, the energy consumption of MSA patients increased significantly in all directions, in all test environments, in each energy frequency band. There was significant difference in energy distribution between MSA-P group and MSA-C group (P0.01). The difference of energy distribution between MSA-P group and MSA-C group was mainly in the high frequency range (220 Hz).) in each test environment. With the increase of test difficulty, the energy consumption in MSA-C group was significantly higher than that in MSA-P group (P0.05). Conclusion both MSAC and MSA-P showed severe postural balance disturbance in static balance test, but typical postural tremor was found in most MSA-C, and the MSA could be classified accurately by the latter.
【作者单位】：广东三九脑科医院神经内科;广东三九脑科医院神经康复训练中心;
【基金】：广东省医学科研基金立项课题(编号:B2014330)
【分类号】：R742

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