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目的探讨脑白质病变(WMLs)对老年轻度帕金森样体征(MPSs)的影响。方法临床收集335名老年男性,根据MRIT2加权像将WMLs分为4级,以WMLs0级作为对照组,所有受试者进行UP-DRS运动评定,比较不同程度WMLs组UPDRS运动总评分及各单项评分之间的差异。结果(1)与WMLs0级组比较,WMLs2级组UPDRS运动总分、运动迟缓及轴性损害单项评分显著增加(P<0.05),WMLs3级组UPDRS运动总分、强直、运动迟缓和轴性损害单项评分显著增加(P<0.05);与WMLs1级组比较,WMLs2级组UPDRS运动总分、轴性损害单项评分显著增加(P<0.05),WMLs3级组UPDRS运动总分、强直、运动迟缓及轴性损害单项评分显著增加(P<0.05);与WMLs2级组比较,WMLs3级组UPDRS运动总分、运动迟缓和轴性损害单项评分显著增加(P<0.05);(2)logistic回归分析控制了年龄、高血压病、糖尿病后,轻度帕金森样体征尤其运动迟缓和轴性损害与WMLs2～3级密切相关。结论中到重度WMLs会导致或者加重老年MPSs,尤其运动迟缓和轴性损害症状,而较少产生震颤;轻度WMLs相对是一种良性病变;积极防治WMLs可能会改善老年人的MPSs。
Objective To investigate the effect of white matter lesions (WMLs) on mild Parkinson’s-like signs (MPSs) in the elderly. Methods The clinical data of 335 elderly men were collected. According to the MRIT2 weighted images, the WMLs were divided into 4 grades and the WMLs 0 grade was used as the control group. All the subjects were assessed by UP-DRS. The UPDRS total score and the individual scores difference between. Results (1) Compared with WMLs0 group, UPDRS total score, motor retardation and axial damage single score of WMLs2 group increased significantly (P <0.05), WDRs3 UPDRS total score, rigidity, motor retardation and axial damage (P <0.05). Compared with WMLs1 group, UPDRS total score and axial damage single score of WMLs2 group increased significantly (P <0.05), total score of UPDRS total score, rigidity, motor retardation (P <0.05). Compared with WMLs2 group, the score of UPDRS total score, motor retardation and axial damage score of WMLs3 group increased significantly (P <0.05); (2) Logistic regression analysis controlled After age, hypertension, and diabetes mellitus, mild Parkinson’s-like signs, particularly locomotor retardation and axial damage, are closely related to grades 2 and 3 of WMLs. Conclusions Moderate to severe WMLs can cause or aggravate the elderly MPSs, especially the symptoms of motor retardation and axial damage, while less tremors; mild WMLs is a benign lesion; and active prevention and treatment of WMLs may improve MPSs in the elderly.