帕金森病异动症治疗进展  

Progress in the treatment of dyskinesia in Parkinson’s disease

作　　者：仲喆 徐敏[1] 陈韦洁 高欢[1] 叶民[1] ZHONG Zhe;XU Min;CHEN Weijie;GAO Huan;YE Min(Department of Neurology,BenQ Medical Center Affiliated of Nanjing Medical University,Jiangsu Province,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院神经内科,江苏南京210019

出　　处：《中国医药导报》2021年第14期39-42,共4页China Medical Herald

基　　金：国家重点研发计划项目(2017YFC1310300)。

摘　　要：左旋多巴诱导的异动症是帕金森病患者长期接受左旋多巴治疗引起的并发症。针对左旋多巴诱导的异动症治疗主要分为药物治疗与非药物治疗两部分。在非药物治疗中脑深部电刺激,单侧苍白球切开术认为是有效的。药物治疗集中在提供持续的多巴胺能刺激,如研制新型多巴胺制剂,儿茶酚-O-甲基转移酶抑制剂,皮下阿扑吗啡和左旋多巴-卡比多巴肠凝胶连续空肠内输注,其次是金刚烷胺、氯氮平、左乙拉西坦等非多巴胺能药物的使用。虽然多数非多巴胺能的药物临床前结果令人鼓舞,但由于其效果的不确定以及带来的副作用,目前向临床实践的转化仍然具有挑战性,本文针对左旋多巴诱导的异动症国内外最新治疗进行一个较详细阐述,为日常临床工作提供参考。Levodopa-induced dyskinesia is a complication caused by long-term treatment of Levodopa in patients with Parkinson’s disease.The treatment of Levodopa-induced dyskinesia is mainly divided into two parts,drug therapy and non-drug therapy.In non-drug therapy,deep brain stimulation and unilateral pallidotomy is considered to be effective.Drug therapy focuses on providing continuous dopaminergic stimulation,such as the development of new Dopamine preparations,catechol-O-methyltransferase inhibitors,Subcutaneous Apomorphine and Levodopa-carbidopa enteral gel continuous jejunal infusion,the second is the use of non-dopaminergic drugs such as Amantadine,Clozapine and Levetiracetam.Although the preclinical results of most non-dopaminergic drugs are encouraging,however,due to the uncertainty of its effect and its side effects,at present,the transformation to clinical practice is still challenging.This article describes in detail the latest treatment of Levodopa-induced dyskinesia at home and abroad,so as to provide reference for daily clinical work.

关 键 词：帕金森病 左旋多巴诱导的异动症 病理生理机制 治疗进展 

分 类 号：R742.5[医药卫生—神经病学与精神病学]