摘要目的:探讨特发性正常压力脑积水(iNPH)患者步态障碍的特征。方法:连续纳入2017年3月至2020年7月在航空总医院神经内科病房住院的临床诊断为iNPH患者42例，收集临床资料，对步态特征及日常生活能力进行回顾性研究。结果:42例患者中，男29例(69.0%)，女13例(31.0%)，平均(73.0±8.3)岁，平均病程(3.5±3.0)年，90.5%(38/42)以步态障碍为主诉，61.9%(26/42)有跌倒史。所有患者均有步态异常。3 m起立-步行计时测验(TUG)完成所需时间(27.8±17.0)s，所需时间10 s以内、10～20 s、20 s以上患者比例分别为5.9%(2/34)、35.3%(12/34)、58.8%(20/34)。10 m行走测验有8例患者需要辅助才能行走，34例可独立行走的患者中94.1%(32/34)存在足跟对足尖行走异常和跌倒倾向，76.5%(26/34)存在转身障碍，44.1%(15/34)存在基底增宽和步长缩短，29.4%(10/34)存在躯干平衡障碍，23.5%(8/34)存在拖地行走，8.8%(3/34)存在启动延迟。97.6%(41/42)步数评分异常，90.5%(38/42)时间评分异常。日常生活能力评估(Barthel指数)轻度依赖、中度依赖、重度依赖患者比例分别为71.4%(30/42)、28.6%(12/42)、0%(0/42)，其中轻度依赖患者中56.7%(17/30)有跌倒史。结论:所有iNPH患者表现出步态障碍，对患者日常生活能力造成一定影响，存在较高的跌倒风险，其中步态缓慢、足跟对足尖行走异常、跌倒倾向、转身困难以及步长和步宽异常最易受累。步态早期评价对疾病诊断、预防跌倒和生活能力下降有着重要意义。

abstractsObjective:To investigate the features of gait disorders in patients with idiopathic normal pressure hydrocephalus(iNPH).Methods:Clinical data of 42 patients diagnosed with iNPH admitted to the neurological department of Aviation General Hospital from March 2017 to July 2020 were consecutively collected.The features of gait disturbance and activity of daily living were retrospectively studied.Results:Of the 42 patients, 29 cases(69%)were males, aged(73.0±8.3)years, and 13 cases were females, aged(73.0±8.3)years old.The mean course of disease was(3.5±3.0)years.There were 90.5% of patients(38/42)complained of gait disorders, and 61.9%(26/42)had fall histories.All patients had gait abnormalities.The time for 3m-Timed Up and Go(TUG)test were(27.8±17.0)seconds, and the proportion of patients with the time for 3m-TUG less than 10 seconds, 10~20 seconds and more than 20 seconds were 5.9%(2/34), 35.3%(12/34)and 58.8%(20/34), respectively.In the 10-meter walking test, 8 patients needed assistance.Of the 34 patients who could walk independently, 94.1%(32/34)had tandem walking disturbed and tendency toward falling, 76.5%(26/34)had turning disturbed, 44.1%(15/34)had wide based stride and small steps, 29.4%(10/34)had trunk balance disturbed, 23.5%(8/34)had reduced foot-floor clearance, and 8.8%(3/34)had start hesitation, 97.6%(41/42)had abnormal step counting and 90.5%(38/42)had abnormal time evaluation.The proportion of patients with activity of daily living(Barthel Index)scores of(mild dependence), moderate dependence and severe dependence were 71.4%(30/42), 28.6%(12/42)and 0%(0/42). Of the 30 patients with mild dependence, 56.7%(17/30)had fall histories.Conclusions:In our study, all patients have gait dysfunction, which causes some impact on activity of daily living and a higher risk of falls.Gait slowness, tandem walking disturbed, turning disturbed, tendency toward falling, wide based stride and small steps are the most involved gait characteristics.Early assessment of gait disorders is of great significance in early diagnosis and the prevention of falls and living ability decline.