目的：根据临床特征及震颤的电生理特征异质性对帕金森病（Parkinson’s disease，PD）震颤患者进行 分型。方法：收集具有震颤的PD患者220例的临床特征（包括运动症状、非运动症状、进展速度、病情分期） 以及肌电图震颤分析的电生理参数；基于这些临床特征及电生理参数，应用K均值聚类分析法对220例原发 性PD震颤患者进行分型，K取2-10对应的轮廓系数来确定最优聚类数。 结果：基于上述方法，可将PD震颤 患者聚类为2个亚型：①亚型1（85例）：震颤进展快，左旋多巴反应好，震颤分析显示多为4～6 Hz静止性震 颤；②亚型2（135例）：震颤进展慢，左旋多巴反应差，震颤分析显示多为抖动无规律。2亚型的病程、运动症 状分数、强直分数、震颤分数、轴性症状分数、左旋多巴等效剂量、强直/震颤分数比值、震颤的进展速度、运动 症状及震颤的左旋多巴反应性、上肢静止性、姿势性、意向性、持物性震颤的频率分布及肌肉收缩形式分布 存在显著性差异（均P＜0.05）。结论：PD震颤患者临床特征及震颤电生理特征存在异质性。根据这种异质 性可以将有震颤的PD患者分为2个亚型。

Classify patients with Parkinson’s disease (PD) tremor based on the heterogeneity of clinical features and electrophysiological characteristics of tremor. Methods: Clinical data (including motor symptoms, non-motor symptoms, progression rate, disease stage) and electrophysiological characteristics of 220 patients with PD tremor were collected. Based on these clinical features and electrophysiological parameters, these patients were classified by K-means cluster analysis. We used the silhouette coefficients corresponding to K ranging from 2 to 10 to determine the optimal number of clusters. Results: Based on the above methods, PD patients with tremor were clustered into two subtypes. (1) Subtype 1 (85 cases): rapid progression of tremor, good response to levodopa, and electromyographic analysis showing predominantly 4～6 Hz resting tremor; (2) Subtype 2 (135 cases): slow progression of tremor, poor response to levodopa, and electromyographic analysis revealing irregular jerky movements. Significant differences were observed between the two subtypes in disease duration, motor symptom scores, rigidity scores, tremor scores, axial symptom scores, levodopa-equivalent doses, rigidity/tremor score ratios, progression rates of tremor, responsiveness of motor symptoms and tremor to levodopa, frequency distribution of upper limb resting, postural, intentional, and postural action tremors, as well as patterns of muscle contraction (all P<0.05). Conclusion: There is heterogeneity in both clinical features and electrophysiological characteristics of PD patients with tremor. Based on this heterogeneity, PD patients with tremor can be classified into two subtypes.