药源性帕金森综合征临床特征及诊断进展

Advances in diagnosis and clinical features of drug-induced Parkinsonism

药源性帕金森综合征(DIP)是由抗精神病药、钙离子通道拮抗剂、胃肠道动力药和抗癫痫药等所致的常见并发症,是中老年人最常见的继发性帕金森综合征。各种药物所致的DIP在临床上并不少见,然而却易漏诊漏治。停药是主要的治疗方法,如无法停药则应换用风险较低的药物。文中就DIP的定义、危险因素、发病机制、临床特征、诊治和预后相关进展做一综述,以提高对这种可防可治的医源性疾病的认识。

Drug-induced Parkinsonism(DIP)is a common complication of antipsychotic drugs,calcium channel antagonists,gastrointestinal prokinetic drugs,and antiepileptic drugs and the most common secondary Parkinsonism in the elderly.DIP caused by various drugs is not uncommon in clinic.However,it is easy to omit diagnosis and treatment.Withdrawal of offending drugs is the main treatment and lower risk drugs should be switched if the drug in use cannot be discontinued.The advances in definition,risk factors,pathogenesis,clinical features,diagnosis and treatment,and prognosis of DIP are reviewed in this paper,in order to improve cognition for this curable iatrogenic disease in clinical practice.