帕金森病运动并发症的预防与治疗

Prevention and management of motor complications in Parkinson disease.

帕金森病(Parkinson disease,PD)是一种常见的中枢神经系统退行性疾病,左旋多巴替代治疗是其主要的治疗方法。随着疾病进展,长期使用左旋多巴会导致运动并发症的发生,使PD患者的临床表现变得极其复杂,治疗也极具挑战性。如何预防和延缓运动并发症的发生成为PD专业医生面临的重要临床难题。选择多靶点联合用药并尽量减少左旋多巴剂量作为PD早期的起始治疗,同时维持稳定的左旋多巴血药浓度,可以有效减少或延缓运动症状波动和异动症的发生。不同类型运动并发症的发生机制和治疗策略各不相同,明确其类型是采取合理预防和治疗的前提。

Parkinson disease(PD)is a common degenerative disease of the central nervous system.Levodopa replacement therapy is currently the main treatment method.With the pathological progress of the disease,long-term use of levodopa will induce motor complications,making the clinical manifestations of PD patients extremely complicated and the treatment difficult to implement.How to prevent and delay the occurrence of motor complications remains an important clinical challenge faced by PD specialists.Selecting multidrug combination therapy,minimizing the dose of levodopa as the initial treatment for PD in the early stage,and maintaining a stable plasma concentration of levodopa,can effectively reduce and delay the occurrence of motor fluctuations and dyskinesias.The mechanisms and treatment strategies of different types of motor complications are different,and the identification of disease types is the prerequisite for reasonable prevention and treatment.