课件：潍坊帕金森病治疗.ppt

* * * In the healthy brain, nigrostriatal neurons fire continuously, therefore, striatal dopamine receptors are normally exposed to relatively constant levels of dopamine and are in a constant state of activity In PD, there is a progressive degeneration of nigrostriatal neurons resulting in a reduction of dopamine levels in the striatum. As a result, the number of activated dopamine receptors is reduced Dopamine can be supplemented with levodopa. However, the short-half life of conventional levodopa results in alternating high and low levels of levodopa to the brain With continued neuronal degeneration and surges of levodopa to the brain followed by deep troughs in levodopa levels, the dopamine receptors are exposed to oscillating levels of dopamine, known as pulsatile stimulation * 我们可以通过一下几种措施来对运动并发症进行控制：改用控释剂型，增加剂量约30％；减少多巴胺用量；加用半衰期较长的多巴胺激动剂；加用COMTI类药物；寻找交叉点：取得较好疗效而不引起波动症状；增加服药次数，但是每日剂量应保持不变。 * 正是由于普拉克索在药理和临床上的特性，目前国外各大学会的指南中（如美国神经病学会和全球帕金森学会等）都已把非麦角类受体激动剂作为帕金森病治疗的一线用药。 建议年龄低于70岁，无认知功能障碍的PD患者应首选非麦角类多巴胺受体激动剂作为起始治疗方案。 * 我们可以通过一下几种措施来对运动并发症进行控制：改用控释剂型，增加剂量约30％；减少多巴胺用量；加用半衰期较长的多巴胺激动剂；加用COMTI类药物；寻找交叉点：取得较好疗效而不引起波动症状；增加服药次数，但是每日剂量应保持不变。 * 我们可以通过一下几种措施来对运动并发症进行控制：改用控释剂型，增加剂量约30％；减少多巴胺用量；加用半衰期较长的多巴胺激动剂；加用COMTI类药物；寻找交叉点：取得较好疗效而不引起波动症状；增加服药次数，但是每日剂量应保持不变。 * Surgical treatments can be roughly divided into three categories. The first is ablative, in which stereotactic lesions are made in very specific anatomical locations within the brain. The second is deep brain stimulation, in which an electrode is placed within specific areas of the brain and a high-frequency pulsatile voltage is used to mimic the effects of ablation. The third is cell transplantation, in which cells are placed into the striatum of the brain in an attempt to mimic the function of substantia nigra cells which perish in Parkinson’s disease. * Surgical treatments can be roughly divided into three categories. The first is ablative, in which stereotactic lesions are made in very specific an