药源性帕金森综合征临床分析  

Clinical analysis of drug-induced Parkinsonism

作　　者：闵喆 薛峥 连立飞[1] MIN Zhe;XUE Zheng;LIAN Lifei(Tongji Hospital,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中国实用神经疾病杂志》2021年第18期1609-1616,共8页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然基金重大研究计划项目(编号:91849121)。

摘　　要：目的分析药源性帕金森综合征(DIP)的临床特点,以及原发性帕金森病的鉴别诊断及治疗体会。方法回顾性分析21例诊断为DIP患者的临床资料。结果21例患者均有明确的用药史,用药14 d~2 a后出现帕金森综合征表现,19例双侧肢体起病,2例单侧起病。临床表现以行动迟缓、肌强直和震颤为主,部分患者合并迟发性运动障碍、静坐不能或肌张力障碍。停用相关药物并予以对症治疗后,多数患者症状缓解,但少数患者症状持续时间较长。结论DIP的临床特点与原发性帕金森病类似,但不尽相同。DIP最好的治疗是预防,尽管多数患者预后较好,但仍影响患者生活质量并造成较重的经济负担,因此使用相关药物应严格把握适应征及禁忌证,控制疗程与用药剂量并加强监测。Objective To investigate the clinical features,differential diagnosis and treatment of drug-induced parkinsonism(DIP).Methods A retrospective analysis of 21 cases with clinically diagnosed DIP was conducted.Results All 21 patients had a clear history of drug use,and symptoms of Parkinson’s syndrome appeared 14 days to 2 years after medication,19 patients had bilateral limb onset,and 2 patients had unilateral onset.The clinical manifestations were sluggish,myotonic and tremor,and some patients were complicated with tardive dyskinesia,asthenia or dystonia.After discontinuation of related drugs and symptomatic treatment,most patients’symptoms were relieved,but a few patients’symptoms lasted for a long time.Conclusion The clinical characteristics of DIP are similar to,but different from,primary Parkinson's disease.The best treatment for DIP is prevention.Although most patients have a good prognosis,it still affects the quality of life of patients and causes a heavy economic burden.Therefore,the use of relevant drugs should strictly understand the indications and contraindications,control the course and dosage of drugs and strengthen monitoring.

关 键 词：药源性帕金森综合征 帕金森病 临床特点 鉴别诊断 不良反应 

分 类 号：R742.5[医药卫生—神经病学与精神病学]