摘要
帕金森病(PD)是一种常见于中老年人的神经退行性疾病,多巴胺替代疗法是PD患者最常用的治疗方法。然而,长期服用左旋多巴会诱导异动症(LID)的发生。如果能更好地了解LID的病理生理机制和治疗方法,一方面可以促进患者的合理用药,降低药物不良反应;另一方面,可以提高患者的生活质量,延长生命周期。文中从LID的发病机制出发,阐述了针对不同类型LID的药物调整方式以及国内外关于LID的最新治疗研究进展。总之,除了多巴胺能药物的新型制剂外,金刚烷胺、5-羟色胺受体激动剂、肾上腺素受体拮抗剂等非多巴胺能药物以及脑深部电刺激、经颅磁刺激等非药物治疗都是未来改善LID的干预方向。此外,临床医生也应该更多关注这些新兴疗法的不良反应。
Parkinson’s disease(PD)is a common neurodegenerative disease in middle-aged and older adults,and levodopa(L-dopa)replacement therapy is the standard treatment method for PD patients.L-dopa-induced dyskinesia(LID)is a common complication of Parkinson’s disease following chronic dopaminergic treatment.If the pathophysiological mechanism and treatment methods of LID can be deeply understood,it can promote the rational use of drugs and reduce adverse drug reactions,improve the quality of life of patients and extend their life expectancy.The medications for different types of LID and the treatment progress of LID at home and abroad were reviewed focusing on the pathophysiological mechanism of LID.In addition to new formulations of dopaminergic drugs,non-dopaminergic drugs such as amantadine,serotonin receptor agonists,adrenoceptor antagonists and deep brain stimulation(DBS),transcranial magnetic stimulation(TMS)are considered to be the future directions.Clinicians should be pay more attention to the adverse effects of these emerging therapies.
作者
苏璐
王坚
SU Lu;WANG Jian(Department of Neurology,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《中国临床神经科学》
2024年第S01期49-55,共7页
Chinese Journal of Clinical Neurosciences
关键词
帕金森病
左旋多巴诱导
异动症
病理生理
治疗
脑深部电刺激
经颅磁刺激
Parkinson’s disease
levodopa-induced
dyskinesia
pathophysiology
treatment
deep brain stimulation
transcranial magnetic stimulation
作者简介
苏璐,神经内科在读博士研究生,主要从事帕金森病分子和环路的机制及干预的研究;通信作者:王坚,E-mail:wangjian_hs@fudan.edu.cn
