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2012 AAN年会:药物导致的迟发性运动障碍康复率低

2012-05-10 陈蓉 医学论坛网

       2012年4月21-28日,第64届美国神经病学会年会在美国新奥尔良召开。会上, 研究者报告,在因抗精神病药物或其他药物导致迟发综合征的患者中,仅约1/8的的患者完全康复。在埃默里大学运动障碍诊所就诊的108例患者中,完全康复率为13%,低于先前报道,埃默里大学运动障碍诊所的Deepti Zutshi博士说。她在AAN年会上

       2012年4月21-28日,第64届美国神经病学会年会在美国新奥尔良召开。会上, 研究者报告,在因抗精神病药物或其他药物导致迟发综合征的患者中,仅约1/8的的患者完全康复。

在埃默里大学运动障碍诊所就诊的108例患者中,完全康复率为13%,低于先前报道,埃默里大学运动障碍诊所的Deepti Zutshi博士说。她在AAN年会上报告了这项单中心研究的结果。

Zutshi指出,既往估计的康复率接近30%。因此,她推断,该研究发现强调了迟发综合征(迟发性运动障碍)的严重性和持久性,提醒医生限制使用导致该病症的药物

迟发性运动障碍是多巴胺受体阻滞剂的副作用之一,这种病况常与抗精神病药物尤其是传统的抗精神病药物如氟哌啶醇和氯丙嗪有关。非典型抗精神病药物导致迟发综合征的风险较低,但仍然有一定风险——大约每年0.8%,而传统抗精神病药物的这一概率为5.4%,据Zutshi报告。她和同事们回顾了其诊所2006~2009年诊断的所有迟发综合征患者,并评估了接受随访的患者。

由于传统的抗精神病药物目前很少应用,仅7%的患者使用了这类药物。非典型抗精神病药物的使用率为36%。1例患者的症状归因于使用选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药,14%的患者可能至少使用了2种违禁药品。胃肠道抗精神病药物导致了42%的迟发综合征,其中甲氧氯普胺的使用率最高(87%),Zutshi报告。大约2/3的患者为女性,平均年龄为59岁。因情绪或精神病症和胃肠不适使用相应多巴胺受体阻滞药物的患者比例分别为44%和41%。患者平均用药时间为4.8年,从开始用药到首次出现运动失调的平均时间为3.6年。所有患者在进入埃默里诊所接受治疗之时已经停用多巴胺阻滞剂,中位随访期为3年,108例患者中有14例康复,Zutshi报告。她和同事们未能找到任何与康复率提高相关的因素。

Zutshi指出了该研究的一些局限性,包括回顾性研究、单中心设计和样本量小等。同时,她报告,一些迟发症状消失的患者可能未再次来诊所就诊。由于研究仅分析了接受随访的患者,因此,康复率可能被大大低估了。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2034382, encodeId=21e02034382f4, content=<a href='/topic/show?id=45eb94588cd' target=_blank style='color:#2F92EE;'>#迟发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94588, encryptionId=45eb94588cd, topicName=迟发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Tue Feb 26 12:44:00 CST 2013, time=2013-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4345, encodeId=1bbb43454e, content=Well done artcile that. I'll make sure to use it wisely., beContent=null, objectType=article, channel=null, level=null, likeNumber=177, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hassan, createdTime=Sun Jun 03 12:33:00 CST 2012, time=2012-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368770, encodeId=b54f1368e702a, content=<a href='/topic/show?id=b40b9423884' target=_blank style='color:#2F92EE;'>#运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94238, encryptionId=b40b9423884, topicName=运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Sat May 12 04:44:00 CST 2012, time=2012-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446405, encodeId=04291446405e2, content=<a href='/topic/show?id=2e3016e437' target=_blank style='color:#2F92EE;'>#AAN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1674, encryptionId=2e3016e437, topicName=AAN)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIt6X4iaHW8bDticcBSHUibNWk4Koe2icf0pdIOicSueicR3AKmviaSNPHkf9bCEicRK0anXEu3DjolU2EmkQ/132, createdBy=98ca5217513, createdName=bluefate123, createdTime=Sat May 12 04:44:00 CST 2012, time=2012-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1506885, encodeId=e9ae15068853d, content=<a href='/topic/show?id=f9699460126' target=_blank style='color:#2F92EE;'>#迟发性运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94601, encryptionId=f9699460126, topicName=迟发性运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a73d9842028, createdName=xlxchina, createdTime=Sat May 12 04:44:00 CST 2012, time=2012-05-12, status=1, ipAttribution=)]
    2012-06-03 hassan

    Well done artcile that. I'll make sure to use it wisely.

    0

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    2012-05-12 bluefate123
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       2012年4月21-28日,第64届美国神经病学会(AAN)年会在美国新奥尔良召开。会上, 研究者报告的一项回顾性研究表明,房颤患者脑出血量可能决定了此后的房颤治疗。 脑出血量平均为2.39ml的患者出血后接受华法林治疗,平均为8.56ml者接受抗血小板治疗,平均为28.9ml者未接受抗凝治疗,据美国伊利诺伊州梅武德L

2012 AAN年会:多发性硬化发病年龄偏小者进展慢

     2012年4月21-28日,第64届美国神经病学会年会在美国新奥尔良召开。会上,研究人员指出,女性和诊断多发性硬化(MS)时年龄小是随后两年或更长时间内疾病呈“良性”的关键标志。       英国伦敦帝国学院的Antonio Scalfari指出,在病程超过10年的“良性”患者中,性别为女性与20年

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