【摘要】：目的探討帕金森病(Parkinson’s disease,PD)患者經(jīng)顱超聲黑質(zhì)高回聲與臨床特征的關(guān)系。方法1以2015年10月-2016年10月就診于河北醫(yī)科大學(xué)第一醫(yī)院神經(jīng)內(nèi)二科的PD患者作為研究對象,共81例,記錄基本資料,包括性別、年齡、發(fā)病年齡、病程及文化程度。2收集患者的臨床特征資料:1)PD家族史、吸煙史和毒物接觸史。2)非運動癥狀:采用問診的方式收集患者的嗅覺障礙、睡眠障礙(快速眼動相睡眠行為障礙(Rapid eye movement sleep behavior disorder,RBD)和過度日間嗜睡)、自主神經(jīng)功能障礙(體位性低血壓、便秘和排尿障礙),采用漢密爾頓焦慮抑郁量表及蒙特利爾認(rèn)知評定量表評估患者神經(jīng)精神障礙(焦慮抑郁情緒和認(rèn)知功能)。3)運動癥狀:采用Hoehn-Yahr分期和統(tǒng)一帕金森病量表第三部分評估患者的運動癥狀。3采用經(jīng)顱超聲(Transcranial sonography,TCS)技術(shù)檢測PD患者黑質(zhì)回聲的強度、面積及高回聲面積/中腦面積(S/M)比值,根據(jù)回聲強度將患者分為病例組(黑質(zhì)高回聲組)和對照組(黑質(zhì)正�；芈暯M)。4分析患者黑質(zhì)高回聲和上述臨床特征的關(guān)系。結(jié)果1 73例PD患者(8例因顳窗條件差而未能探測)黑質(zhì)回聲Ⅰ~Ⅴ級的人數(shù)分別為0、28、35、8及2例,病例組45例(61.6%),對照組28例(38.4%)。2病例組中31例(68.9%)患者黑質(zhì)高回聲側(cè)位于運動癥狀嚴(yán)重的對側(cè),5例(11.1%)患者位于同側(cè),9例(20.0%)患者雙側(cè)黑質(zhì)回聲均增強,黑質(zhì)高回聲的側(cè)別與運動癥狀重的側(cè)別有顯著關(guān)聯(lián)性(P0.01)。3不同黑質(zhì)回聲級別患者的高回聲面積和S/M值均具有顯著差異(P0.01)。4單因素分析發(fā)現(xiàn)吸煙的PD患者出現(xiàn)黑質(zhì)高回聲的危險性低于不吸煙的患者(0R=0.375,P0.05),伴嗅覺障礙的PD患者出現(xiàn)黑質(zhì)高回聲的危險性高于不伴嗅覺障礙的患者(0R=4.531,P0.05),伴RBD的PD患者出現(xiàn)黑質(zhì)高回聲的危險性高于不伴RBD的患者(0R=3.422,P0.05)。5多因素分析發(fā)現(xiàn)男性和嗅覺障礙是PD患者出現(xiàn)黑質(zhì)高回聲的危險因素(OR=17.594/8.949,P0.05)。結(jié)論1 PD患者黑質(zhì)高回聲側(cè)多位于肢體運動癥狀較重側(cè)的對側(cè)。2 PD患者黑質(zhì)回聲強度的等級、高回聲面積和S/M值均可反映黑質(zhì)回聲強度的情況。3吸煙的PD患者出現(xiàn)黑質(zhì)高回聲的危險性低;男性、伴嗅覺障礙或RBD的PD患者出現(xiàn)黑質(zhì)高回聲的危險性高于女性、不伴嗅覺障礙或RBD的患者。
[Abstract]:Objective to investigate the relationship between transcranial sonographic hyperechogenicity and clinical features in patients with Parkinson's disease (PD). Methods 1 A total of 81 PD patients from October 2015 to October 2016 in the Department of Neurology, first Hospital of Hebei Medical University, were studied. The basic data, including sex, age, age of onset, were recorded. Course of disease and education. 2. Collect the clinical characteristic data of the patient: 1) PD family history, smoking history and toxicant contact history .2) Non-motor symptom: collect the patient's olfactory disorder by means of inquiring. Sleep disorder (Rapid eye movement sleep behavior disorderia) and excessive daytime sleepiness, autonomic dysfunction (postural hypotension), Constipation and dysuria), using the Hamilton anxiety and Depression scale and the Montreal Cognitive rating scale to assess the motor symptoms of neuropsychiatric disorders (anxiety, depression and cognitive function): using Hoehn-Yahr staging and unifying Parkinson's The third part of the scale was used to assess the intensity of substantia nigra echo in PD patients by transcranial ultrasound (TCS). According to the echo intensity, the patients were divided into two groups: the case group (the hyperechoic group) and the control group (the normal echoic group). 4. The relationship between the hyperechoicity of the substantia nigra and the above clinical characteristics was analyzed. Results the number of 鈪，

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