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血管性帕金森综合征患者的临床研究

时间:2019-03-23
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第五篇临床医学硕士论文标题:血管性帕金森综合征患者的临床研究

摘 要

  本篇文章目录导航:

  【题目】血管性帕金森综合征患者的临床研究
  【第一章-第二章】VP患者和PD患者资料及研究方法
  【第三章】血管性帕金森和帕金森病患者临床比较结果
  【第四章】血管性帕金森综合征相关因素讨论
  【参考文献】血管性帕金森患者临床表现探究结论与参考文献

  血管性帕金森综合征(Vascular pakinsonism ,VP)是在脑动脉硬化基础上发生的一类继发性帕金森综合征,由 Critchley 在 1929 年首先提出的。近年来,VP 患者不断增加,VP 发病率持续上升,而目前对于 VP 患者尚无有效的治疗手段,仍处于减轻症状,延缓病程进展阶段,因此及早识别危险因素和 VP 的发生,尽早进行有效干预,对于预防本病的发生发展意义重大。

  目的:通过对登记入组的血管性帕金森综合征患者和帕金森病(Parkinson'sdisease, PD)患者的基本信息资料进行分析比对,探讨 VP 的独特临床特征及影响因素,为 VP 患者的早期识别及治疗提供临床依据。

  方法:采用回顾性研究方法,选取于 2015 年 9 至 2017 年 12 月收治于邯郸市第一医院神内一科住院的符合纳入标准及排除标准的 VP 患者 46 例及 PD 患者 28例,收集两组患者的一般人口学资料、既往病史、临床症状、实验室血液标本检验结果,应用 SPSS 25.0 软件分析 VP 患者的相关因素,P<0.05 有统计学意义。

  结果:①VP 患者的平均年龄较 PD 患者高。②VP 组和 PD 组之间受教育水平存在统计学差异(P<0.05),PD 患者受教育水平在小学以下者明显多于 VP 患者。

血管性帕金森综合征患者的临床研究

  ③VP 组和 PD 组之间静止性震颤、肌强直、锥体束征、认知功能障碍、嗅觉减退比例存在统计学差异(P<0.05),VP 患者的静止性震颤、嗅觉减退比例低于 PD患者,VP 患者的肌强直、认知功能障碍、锥体束征的比例显着高于 PD 患者。④VP 组和 PD 组之间合并高血压、高脂血症、糖尿病、基底节区多发腔隙性脑梗死的比例存在统计学差异(P<0.05),VP 患者合并高血压、糖尿病、高血脂、基底节区多发腔隙性脑梗死比例显着高于 PD 患者。⑤VP 组和 PD 组之间的同型半胱氨酸、超敏 C 反应蛋白、低密度脂蛋白的比例存在统计学差异(P<0.05),VP组患者的同型半胱氨酸、超敏 C 反应蛋白、低密度脂蛋白比例显着高于 PD 组患者。

  结论:①VP 患者与 PD 患者相比,临床症状上更容易出现肌强直、锥体束征、认知功能障碍,而 PD 患者的静止性震颤、嗅觉减退较 VP 患者更为多见。②年龄、高血压、基底节区多发腔隙性脑梗死、同型半胱氨酸是 VP 产生的独立危险因素。

  关键词:血管性帕金森综合征;帕金森病;相关因素

Abstract

  Vascular Parkinson syndrome (VP) is a secondary Parkinson syndrome on the basis of cerebral arteriosclerosis, which was first proposed by Critchley in 1929. In recent years, VP patients continue to increase, the incidence of VP continues to rise, but at present, there is no effective treatment for VP patients, still in alleviating symptoms and delaying the progress of the course of disease. Therefore, early identification of risk factors and the occurrence of VP and early effective intervention are of great significance in preventing the occurrence and development of the disease.

  Objective:Through the analysis and comparison of basic informational data of patients with vascular Parkinson's disease and Parkinson's disease (PD) who were enrolled in the study, the unique clinical features and influencing factors of VP were explored for the early identification of VP patients. Treatment provides clinical basis.

  Methods:The retrospective study method was used to select 46 VP patients and 28 PD patients who were hospitalized in the first hospital of Handan from September 2015 to December 2017. The general demographic data, past medical history, clinical symptoms, laboratory blood specimen examination results were collected, and S was applied. PSS 25 software was used to analyze the related factors of VP patients, P < 0.05 had statistical significance.

  Result: ①The average age of VP patients is higher than that of patients with PD.② There is a statistical difference between the two groups. The education level of PD patients is significantly more than that of VP patients under primary school.③ There were statistical differences between the two groups in the ratio of resting tremor, muscle rigidity, cognitive dysfunction, pyramidal tract sign, and olfactory dysfunction.The resting tremor and hyposmia of VP patients were lower than those of PD patients. The proportion of myotonia, cognitive impairment, and pyramidal tract sign was higher in VP patients than in PD patients.④ There was a statistical difference in the proportion of ypertension, diabetes, hyperlipidemia and multiple lacunar infarction in basal ganglia between the two groups.The proportion of hypertension, diabetes, hyperlipidemia and multiple lacunar infarction in basal ganglia in VP patients was significantly higher than that in PD patients. ⑤There was a statistical difference between the two groups of hypersensitivity C, homocysteine, and low density lipoprotein,The hypersensitivity C, homocysteine, and low density ipoprotein in VP patients were significantly higher than those in PD patients.

  Conclusion:①  Compared with patients with PD, patients with VP were more likely to have muscle rigidity, cognitive dysfunction, pyramidal tract sign, and PD patients had more tremors and olfactory disorders than VP. ②Age, hypertension, multiple lacunar infarction in the basal ganglia, and homocysteine are independent risk factors for VP production.

  Keywords: Vascular parkinsonism; Parkinson's Disease; Correlate factors

目 录

  摘 要
  Abstract
  第 1 章 前言
  第 2 章 资料及方法
    2.1 研究对象
    2.2 纳入标准
      2.2.1 血管性帕金森综合征的纳入标准
      2.2.2 帕金森病的纳入标准
    2.3 排除标准
      2.3.1 血管性帕金森综合征的排除标准
      2.3.2 帕金森病排除标准
    2.4 研究方法
    2.5 相关定义
    2.6 统计学方法
  第 3 章 结果
  第 4 章 讨论
  结论
  致谢
  参考文献
  附录
  作者简介
  发表论文和参加科研情况说明


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