揭示帕金森病患者运动迟缓的相关因素

Related factors of bradykinesia in Parkinson disease

目的:运动迟缓是造成帕金森病的主要特征,而肌无力、强直、震颤、运动多变、思维缓慢是其主要影响因素,而产生这些现象的机制是非常复杂的。资料来源:应用计算机检索“Medline”1980-01/2004-04的关于帕金森病运动迟缓的病理生理学机制的文章,检索词“Parkinsondisease,bradyki-nesia,pathophysiology”,限定文章语言种类为“English”。资料选择:对资料进行初审,选取旨在探讨帕金森病运动迟缓相关影响因素的随机对照试验的文献,对选取的文献进行查找全文,排除重复研究。资料提炼:共选取36篇探讨帕金森病运动迟缓的相关文献,其中32篇文献与之相关,排除4篇重复研究。资料综合:总结所选文献中关于帕金森病运动迟缓的发病机制的内容,按照影响运动迟缓因素等几方面进行归类分析。其中6篇文献分析了运动迟缓的5种因素,15篇文献对帕金森病的发病机制及其他疾病做了比较,7篇文献对动物模型及手术机制做了探讨,支持手术可以改善帕金森病患者的运动功能。结论:运动迟缓的主要缺陷是运动减慢,在运动起始时肌力的反射强度不足,结果运动时偏离了所要达到的目的,而要采用多个小步来达到,由于在主动运动时运动命令设定的阈值低下而引起。

OBJECTIVE:Parkinson disease is a progressive neurodegenerative disease mainly characterized by bradykinesia,and influenced by the factors including myasthenia,muscular rigidity,tremor,sports diversity and slow thinking,but the mechanisms of the phenomena are complicated.DATA SOURCES:The articles related to the pathophysiological mechanism of bradykinesia in Parkinson disease published in English between January 1980 and April 2004 were searched for in Medline by using computer with theKeywords“Parkinson disease,bradykinesia,pathophysiology'.STUDY SELECTION:Through the primary trial to the articles,the literatures concerning the related influencing factors of bradykinesia in Parkinson disease in randomized controlled experiments were selected,then full texts of them were looked up,and the repeated studies were excluded.DATA EXTRACTION:Totally 36 articles related to bradykinesia of Parkinson's disease were collected,among which 32 were relevant and 4 were excluded due to their repetition.DATA SYNTHESIS:The pathogenesis of bradykinesia in Parkinson's disease was summarized in the 32 articles.The factors influencing bradykinesia and other aspects were classified and analyzed.In the 32 articles,5 factors of bradykinesia were analyzed in 6 articles,the pathogenesis of Parkinson's disease were compared with that of other disease in 15 articles and the animal models and operation mechanisms were investigated in 7 articles.Supportive operation could improve the motor function of patients with Parkinson disease.CONCLUSION:The main defect of bradykinesia mainly manifests as slow movement.When the movement begins,the reflection strength of muscle force becomes weak,resulting in movement departure to the objective,which then needs many steps to accomplish.Bradykinesia results from drops of the defined threshold of movement demands in active movement.