摘要目的: 探讨震颤分析和肛门括约肌肌电图(external anal sphincter electromyography,EAS-EMG)在帕金森病(Parkinson's disease,PD)和多系统萎缩P型(Multiple system Atrophy-parkinson,MSA-P)患者中的差异。方法: 选择徐州医科大学附属医院神经内科收治的PD患者50例,MSA-P患者25例。根据H&Y分期,将帕金森病患者分为H&Y为0-3级的早-中期PD组(27例),H&Y为4~5级的晚期PD组(23例)及MSA-P组(25例),同时检测三组的震颤分析和肛门括约肌肌电图情况,分析三组患者震颤分析及肛门括约肌肌电图的各项指标的差异。结果: PD组与MSA-P组患者静息性震颤发生率帕金森病组高于MSA-P组(P<0.05),震颤频率及姿势性震颤发生率对比差异无统计学意义; 早-中期PD组静息性震颤及姿势性频率均高于晚期PD组(P<0.05),两组均以静息性震颤为主,但两组静息性震颤及姿势性震颤发生率差异无统计学意义(P>0.05);早-中期PD组与MSA-P组比较,静息性震颤发生率更高(P<0.05),姿势性震颤发生率差异无统计学意义;MSA-P组与PD组比较,EAS-EMG的轻微收缩时运动单位(motion unit of anal sphincter during slight constract,MUAP)平均时限延长、多相波百分比显著增高、卫星电位出现率增多(P<0.05);晚期PD组EAS-EMG与早-中期PD组相比,MUAP平均时限延长、多相波百分比显著增高、卫星电位出现率增多(P<0.05);早-中期PD组与MSA-P组相比,EAS-EMG MUAP平均时限缩短(P<0.05),多相波百分比及卫星出现率下降(P<0.05)。结论: 震颤分析及肛门括约肌肌电图和帕金森病病情进展相关,并可能为MSA-P型和早-中期PD患者的鉴别提供依据。
Abstract：Objective: To investigate the differences in tremor analysis and external anal sphincter electromyography(EAS-EMG) in Parkinson's disease (PD)and P-type Multiple system Atrophy patients ( MSA-P).Methods: Fifty PD patients and twenty-five MSA-P patients treated at the Department of Neurology, Affiliated Hospital of Xuzhou Medical University, were selected. According to the H&Y staging, PD patients were divided into early-middle stage PD group (H&Y 0-3, 27 cases) and late-stage PD group (H&Y 4~5, 23 cases), along with the MSA-P group (25 cases). Tremor analysis and EAS-EMG were performed for all three groups, and the differences in various indices of tremor analysis and EAS-EMG among the three groups were analyzed.Results: The incidence of resting tremor was higher in the PD group compared to the MSA-P group (P<0.05), with no significant differences in tremor frequency and postural tremor incidence. In the early-middle stage PD group, both resting tremor and postural tremor frequencies were higher than in the late-stage PD group (P<0.05), with resting tremor being predominant in both groups. However, there were no statistically significant differences in the incidence of resting tremor and postural tremor between the two groups (P>0.05). The incidence of resting tremor was higher in the early-middle stage PD group compared to the MSA-P group (P<0.05), with no significant difference in the incidence of postural tremor. Compared with the PD group, the MSA-P group had a prolonged average duration of motion unit of the anal sphincter during slight contraction (MUAP), a significantly higher percentage of polyphasic waves, and a higher incidence of satellite potentials (P<0.05). In the late-stage PD group compared to the early-middle-stage PD group, there was a prolonged average duration of MUAP, a significantly higher percentage of polyphasic waves, and a higher incidence of satellite potentials (P<0.05). Compared to the MSA-P group, the early-middle stage PD group had a shorter average duration of MUAP (P<0.05), a lower percentage of polyphasic waves, and a lower incidence of satellite potentials (P<0.05).Conclusion: Tremor analysis and EAS-EMG are associated with the progression of Parkinson's disease and may provide a basis for differentiating between MSA-P and early-middle-stage PD patients.
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2024, Vol. 30 
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