【摘要】 目的 研究不同亞型多系統萎縮（multiple system atrophy，MSA）患者的臨床特點。 方法 回顧分析2009年1月—2011年1月收治的105例“很可能的”MSA患者的臨床資料，包括發病年齡、首發癥狀、臨床表現、治療反應性等。 結果 105例MSA患者中，男57例，女48例，發病年齡58歲。以小腦性共濟失調為主要特點的MSA（MSA with predominant cerebellar ataxia，MSA-C）患者76例，以帕金森綜合征為主要特點的多系統萎縮（MSA with predominant parkinsonism，MSA-P）患者29例。39例患者僅以小腦功能障礙為首發癥狀；29例患者僅以帕金森綜合征為首發癥狀，23例患者僅以自主神經功能障礙為首發癥狀，其余14例患者的首發表現至少包括2種癥狀組合。至最后一次隨訪時，54例患者同時存在小腦功能障礙、帕金森綜合征、自主神經功能障礙和錐體束征，51例患者表現為自主神經功能障礙與小腦功能障礙和（或）帕金森綜合征的不同形式的組合。 結論 MSA患者以MSA-C為主。由于在病程早期，MSA與其他帕金森綜合征或小腦性共濟失調疾病的鑒別較為困難，因此，仔細動態觀察患者臨床特點的演變情況，對MSA的診斷至關重要。
【Abstract】 Objective To investigate subtypes and clinical features of multiple system atrophy (MSA). Methods The clinical data of 105 probable MSA patients treated in our hospital from January 2009 to January 2011 were analyzed, including the age at onset, initial symptoms, clinical manifestations and responsivity to levodopa. Results The 105 probable MSA patients consisted of 57 males and 48 females, including 76 patients (72.4%) of MSA with predominant cerebellar ataxia (MSA-C) and 29 patients (27.6%) of MSA with predominant parkinsonism (MSA-P). The mean age at onset was 58 years. The initial symptom of 39 patients was pure cerebellar dysfunction. Twenty-nine patients presented pure parkinsonism as the initial symptom. The initial symptom of 23 patients was pure dysautonomia. By the last clinical visit, 54 patients had cerebellar dysfunction, parkinsonism, autonomic failure and pyramidal signs. Conclusion The study revealed a predominance of MSA-C patients. The differentiation of MSA and other forms of parkinsonism or cerebellar ataxia may be difficult at the early stage. For more accurate diagnosis, it is important to carefully observe the clinical progression.
引用本文： 趙璧,黃睿,宋偉,商慧芳. 多系統萎縮患者的臨床特點分析. 華西醫學, 2011, 26(5): 663-666. doi: 復制