帕金森病中左旋多巴诱导异动症的发病机制和治疗进展
Pathophysiological Mechanism and Treatment Updates on Levodopa-induced Dyskinesia in Parkinson's Disease
苏璐 1王坚1
作者信息
- 1. 复旦大学附属华山医院神经内科,上海 200040
- 折叠
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.
Abstract
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.
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Key words
Parkinson's disease/levodopa-induced/dyskinesia/pathophysiology/treatment/deep brain stimulation/transcranial magnetic stimulation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据