摘要
目的：分析Shy-Drager综合征的临床特征，降低误诊率。方法：对30例Shy-Drager综合征患者的临床特征、辅助检查、治疗及误诊情况进行回顾性分析。结果：30例患者均有直立性低血压的临床表现，以发作性头晕为首发症状者多见，病程中73．3％的患者有发作性头晕，23．3％的患者发生晕厥，50％有排尿障碍，46．7％的患者出汗异常，56％的男性病人伴有阳痿，平均2年后，部分患者出现锥体外系、小脑、脑干等损害症状。6．7％的患者ECG示窦性心动过缓，26．7％的患者头颅MRI检查示小脑萎缩，10％的患者脑干听觉诱发电位中枢段检查异常。12例排尿障碍的病人被误诊为前列腺肥大，误诊率为40％，2例患者被误诊为帕金森病，误诊率为6．7％，30例患者均辅以中药治疗，症状有所缓解。结论：30例Shy-Drager综合征患者均表现为不同程度的自主神经受损，中药治疗提供了一条新的治疗途径。因该病临床症状多变以及临床医生对该病的认识不足而易误诊，所以加强对本病的认识，早期诊治具有重要意义。
Objective： To analyze the clinical features of 30 patients with Shy-Drager syndrome（SDS） and to reduce misdiagnosis. Methods： Clinical symptoms and misdiagnoses were studied in 30 SDS patients. Results： All the 30 patients （25 males and 5 females） had orthostatic hypotension. Postural faintness was the initial and main clinical lecture. During the course of the disease, postural faintness was present in 73.3%, recurrent syncope in 23.3%, urinary disturbance in 50%, perspiring abnormlity in 46.7% of the patients, and .56% of male patients suffered impotence. About two years later, brainstem, cerebellum and expyramidal involvement appear in most of the patients. ECG showed that 6.7 % of patients had sinus bradycardia; MRI scan showed 26.7 % of patients had atrophic cerebellum; brainstem auditory evoked potential （BAEP） showed 10% of patients were abnormal in central segment. 12 patients with urinary disturbance were diagnosed as prostatic hypertrophy, and the misdiagnosis rate is 40%; 2 patients were diagnosed as Parkinson＇s disease, and the misdiagnosis rate is 6.7 %. The 30 patients had improved mildly by treatment with Chinese traditional medicine. Conclusion： 30 patients with Shy-Drager syndrome had autonomic dysfunction to various degrees. Symptomatic therapeutic strategies are still limited, Chinese traditional medicine therapy may open a new avenue of treatment. Because of various clinical features and the limited knowledge about this disease, it is often difficult to make a correct diagnosis, so to increase the awareness of the disease and diagnose early will be important.
出处
《脑与神经疾病杂志》
2005年第5期327-329,共3页
Journal of Brain and Nervous Diseases
