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《中国帕金森病的诊断标准(2016版)》发布

2016-07-11 中华神经科杂志 中华神经科杂志

近10年来,国内外在帕金森病的病理和病理生理、临床表现、诊断技术等方面有了更深入、全面的认识。为了更好地规范我国临床医师对帕金森病的诊断和鉴别诊断,中华医学会神经病学分会帕金森病及运动障碍学组在英国UK脑库帕金森病临床诊断标准的基础上,参考了国际运动障碍学会(MDS)2015年推出的帕金森病临床诊断新标准,结合我国的实际,对我国2006年版的帕金森病诊断标准进行了更新。帕金森综合征诊断标准帕金森综

近10年来,国内外在帕金森病的病理和病理生理、临床表现、诊断技术等方面有了更深入、全面的认识。为了更好地规范我国临床医师对帕金森病的诊断和鉴别诊断,中华医学会神经病学分会帕金森病及运动障碍学组在英国UK脑库帕金森病临床诊断标准的基础上,参考了国际运动障碍学会(MDS)2015年推出的帕金森病临床诊断新标准,结合我国的实际,对我国2006年版的帕金森病诊断标准进行了更新。

帕金森综合征诊断标准帕金森综合征的确诊是帕金森病治疗的先决条件。帕金森综合征的诊断基于3个核心运动症状,即必备运动迟缓和至少存在静止性震颤或肌强直2项中的1项。

临床确诊的帕金森病需要具备:(1)不存在绝对排除标准。(2 )至少存在2 条支持标准。(3)没有警示征象。

临床很可能的帕金森病需要具备:(1)不符合绝对排除标准。( 2 ) 如果出现警示征象则需要通过支持标准来抵消:如果出现1条警示征象,必须有至少1条支持标准抵消;如果出现2条警示征象,必须有至少2条支持标准抵消;如果出现2条以上警示征象,则诊断不能成立。

支持标准(1)患者对多巴胺能药物治疗效果明确且显著。(2)出现左旋多巴诱导的异动症。(3)临床体检观察到单个肢体的静止性震颤(既往或本次检查)。(4)辅助检测。

绝对排除标准(1)存在明确的小脑性共济失调,或者小脑性眼动异常。(2)出现向下的垂直性核上性凝视麻痹或向下的垂直性扫视选择性减慢。(3)在发病后5年内,患者被诊断为高度怀疑的行为变异型额颞叶痴呆或原发性进行性失语等。

警示征象(1)发病后5年内出现快速进展的步态障碍,以至于需要经常使用轮椅。(2)运动症状或体征在发病后5年内或5 年以上完全不进展,除非这种病情的稳定与治疗相关。(3 )发病后5 年内出现球麻痹症状,表现为严重的发音困难、构音障碍或吞咽困难等。

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中国帕金森病的诊断标准(2016版) (梅斯医学APP免积分下载)

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    2016-10-11 ylzr123

    好文值得点赞!继续关注学习。

    0

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    2016-07-14 青荷

    新标准,学习了

    0

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    2016-07-12 深海的鱼

    有指导意义了

    0

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    2016-07-11 ann y

    学习涨姿势了

    0

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