继发性偏侧舞蹈症患者疗效差异的相关因素分析

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摘要目的探讨影响继发性偏侧舞蹈症患者疗效差异的相关因素，为早期干预提供参考。方法回顾性分析2012年11月～2017年11月在首都医科大学附属北京潞河医院住院确诊为继发性偏侧舞蹈症的38例患者的临床资料，采用Logistic回归分析探讨影响继发性偏侧舞蹈症疗效的相关因素。结果 38例患者中急性脑血管病23例（60.5%），高血糖非酮症偏侧舞蹈症6例（15.8%），其他病因9例（23.7%）。随访结果显示，患者自觉疗效满意26例（68.4%），疗效不满意12例（31.6%），两组患者年龄、卒中史、发病至首诊时间、病灶部位差异有统计学意义（P < 0.05）。Logistic回归分析显示，既往卒中史（OR = 0.961，95%CI：1.423～61.658，P < 0.05）及病灶部位（OR = 1.0253，95%CI：2.087～283.919，P < 0.05）是继发性偏侧舞蹈症疗效不佳的危险因素。结论继发性偏侧舞蹈症病因以急性脑血管病为主，高血糖次之。高龄、卒中史、发病至首诊时间、病灶部位均可影响患者短期预后，既往卒中史和非基底节或基底节合并其他多部位病灶是继发性偏侧舞蹈症疗效欠佳的高危因素，需引起临床重视。

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	王雪梅王艳玲堵向楠耿晓坤杜会山▲

关键词 ：偏侧舞蹈症, 急性脑血管病, 非酮症性高血糖, 危险因素

Abstract：Objective To investigate the related factors influencing the curative effect in secondary hemichorea patients, and to provide early effective intervention. Methods Clinical data of 38 patients with secondary hemichorea diagnosed in Beijing Luhe Hospital, Capital Medical University from November 2012 to November 2017 was retrospectively analyzed. Logistic regression analysis was used to explore the relevant factors affecting the efficacy of secondary hemichorea. Results Among the 38 patients, 23 (60.5%) were caused by acute cerebrovascular disease, 6 patients (15.8%) by non-ketotic hyperglycemia and 9 patients (23.7%) by other causes. Following up showed that, 26 patients (68.4%) in the group with satisfactory self-efficacy and 12 patients (31.6%) with unsatisfactory efficacy, there were statistically significant difference in age, history of stroke, time from onset to first diagnosis and treatment, and location of lesions between the two groups (P < 0.05). Logistic regression analysis showed that stroke history (OR = 0.961, 95%CI: 1.423-61.658, P < 0.05) and lesion location (OR = 1.0253, 95%CI: 2.087-283.919, P < 0.05) were risk factors for poor outcome in patients with secondary hemichorea. Conclusion Acute cerebrovascular disease is the main etiology of secondary hemichorea, followed by hyperglycemia. Advanced age, stroke history, onset to first diagnosis time and location of lesions, respectively affects short-term prognosis of patients. Previous stroke history and non-basal ganglia or basal ganglia combined with other multi-site lesions are high risk factors for poor efficacy of secondary hemichorea, which should be paid high attention.

Key words： Hemichorea Acute cerebrovascular disease Non-ketotic hyperglycemia Risk factor

基金资助:北京市科技计划课题项目（Z151100003915134）。

通讯作者: ▲通讯作者

引用本文:

王雪梅王艳玲堵向楠耿晓坤杜会山▲. 继发性偏侧舞蹈症患者疗效差异的相关因素分析[J]. 中国医药导报, 2019, 16(17): 50-53.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I17/50

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