CAJ | 학술논문

目的：总结多系统萎缩（multiple system atrophy ，MSA）以非运动症候和运动症候为首发症状的构成比和MSA非运动症候的具体症候构成比。方法选择MSA患者31例，其中MSA-P型18例，MSA-C型13例。进行详细病史记录和神经系统体检，记录运动症候及非运动症候具体表现及出现时间。结果23例M S A以非运动症候首发。非运动症候的首发症状以快速眼动睡眠异常、排尿障碍、性功能障碍及直立性低血压常见。31例M S A患者均有非运动症候表现。以直肠功能障碍（93．5％）、排尿障碍（90．3％）、直立性低血压（64．5％）、睡眠呼吸暂停（61．3％）、快速眼动睡眠异常（48．4％）最为常见。MSA-P型与MSA-C型在年龄、性别、首发病程、就诊病程及非运动症候构成比较，差异无统计学意义（P＞0．05）。结论 MSA患者普遍存在自主神经功能障碍等非运动症候表现，且以首发症状多见。MSA-C型患者中以非运动症候起病较MSA-P型患者更为多见。
목적：총결다계통위축（multiple system atrophy ，MSA）이비운동증후화운동증후위수발증상적구성비화MSA비운동증후적구체증후구성비。방법선택MSA환자31례，기중MSA-P형18례，MSA-C형13례。진행상세병사기록화신경계통체검，기록운동증후급비운동증후구체표현급출현시간。결과23례M S A이비운동증후수발。비운동증후적수발증상이쾌속안동수면이상、배뇨장애、성공능장애급직립성저혈압상견。31례M S A환자균유비운동증후표현。이직장공능장애（93．5％）、배뇨장애（90．3％）、직립성저혈압（64．5％）、수면호흡잠정（61．3％）、쾌속안동수면이상（48．4％）최위상견。MSA-P형여MSA-C형재년령、성별、수발병정、취진병정급비운동증후구성비교，차이무통계학의의（P＞0．05）。결론 MSA환자보편존재자주신경공능장애등비운동증후표현，차이수발증상다견。MSA-C형환자중이비운동증후기병교MSA-P형환자경위다견。
Objective To summarize the constitutional ratio of multiple system atrophy (MSA)ini-tially manifested as nonmotor or motor syndrome .Methods Thirty-one MSA patients were divid-ed into MSA-P type group (n=18) and MSA-C type group (n=13) .Their medical history ,mani-festations and their development time of motor or nonmotor symdrome were recorded .Results MSA was initially manifested as nonmotor syndrome in 23 MSA patients .Its common initial symptoms were rapid eyemovement sleep behavior disorder ,urinary dysfunction ,sexual disorder , and orthostatic hypotension .MSA was initially manifested as motor syndrome in 31 MSA pa-tients .Its common initial symptoms were rectal dysfunction ,urinary dysfunction ,orthostatic hy-potension ,sleep apnea and rapid eyemovement sleep behaviour disorder ,accounting for 93 .5% , 90 .3% ,64 .5% ,61 .3% ,and 48 .4% respectively of its total symptoms .No significant difference was found in nonmotor syndrome and its morbidity between MSA-P type group and MSA-C type group (P>0 .05) .Conclusion MSA patients are usually manifested as nonmotor syndrome such as autonomic nervous dysfunction .Nonmotor syndrome is more commonly observed in MSA-C type patients than in MSA-P type patients .