药源性帕金森综合征的临床分析

Clinical analysis of drug-induced parkinsonism

目的:探讨药源性帕金森综合征(DIP)的临床特点,与原发性帕金森病的鉴别诊断及治疗体会。方法:对84例临床诊断为药源性帕金森综合征患者的资料进行回顾性分析。结果:84例患者均有明确的用药史,用药14d～6年后出现帕金森综合征表现,67.86%在3个月内出现DIP的表现;均双侧肢体对称起病,11例患者以一侧症状较重;临床表现以运动迟缓、肌强直为主;本组患者25%同时出现迟发性运动障碍,10.71%同时合并静坐不能,7.14%同时合并肌张力障碍。异丙嗪、硫必利等药物对症治疗有效。结论:药源性帕金森综合征的临床特点与原发性帕金森病相似,仍有一些特征性的表现可与其相鉴别,两者的治疗不同,药源性帕金森综合征最好的治疗就是预防,给予适当的对症治疗,可改善患者的症状。

Objective： To investigate the clinical features, differential diagnosis and treatment of druginduced parkinsonism （DIP）. Methods： A retrospective analysis of 84 cases with clinically diagnosed DIP was conducted. Results： 84 patients had definitive histories of using drugs. DIP appeared from 14 days to 6 years after taking medicines,67.86% patients appeared within 3 months.The main symptoms of DIP were bradykinesia and rigidity.Onset was bilateralis, symmetric signs, but the symptoms of 11 cases were asymmetric. Simultaneously,25% patients appeared tardive dyskinesia, 10.71% exhibited akathisia, 7.14% appeared dystonia. Some medicines,such as proazamine and Tiapride Hydrchloride were effective to control symptoms. Conclusion： DIP is often clinically similar with primary parkinsonism. However, some clinical characteristics are beneficial to differential diagnosis. The treatment of DIP is differen from primary parkinsonism, the best method is prevention, symptomatic therapy can alleviate clinical symptoms of patients.