锥体外系疾病(2-运动障碍性PPT.ppt

用药方法：由小到大Administration method: the dosage increases gradually副作用：周围性为恶心、低血压，心律失常。中枢性为症状波动、运动障碍、精神症状等。 Side effect: peripheral side effects: nausea, hypotension, arrhythmia. Central side effect: fluctuated symptom, motor disorder, psychiatric symptom, etc. 禁用：前列腺肥大、窄角型青光眼、严重肝肾功能不全。Forbidden: prostatic hypertrophy, narrow angle glaucoma, severe liver and renalInadequacy.长期及大剂量使用可出现：long-term and large dosage will cause: *症状波动：因药物作用时间缩短和血药浓度不稳定，出现剂末运动不能和双向运动障碍。 fluctuated symptom: because of the reduction of drug reaction time, and the astable drug concentration in blood, the end of dose akinesis and bidirection motor disorder appear. 开-关（on-off）现象。低张力冻结现象与药物慢性中毒和病情加重有关，改变用药途径、方法、剂型及阿扑吗啡有时可缓解症状。 on-off phenomenon. low tension freezing phenomenon is related to chronic intoxication and the aggravated disease. Change in the way of administration, dose, dosage form and giving apomorphine some times will relieve these symptoms. *异动症：舞蹈样，手足徐动样或肌阵挛性运动异常，可波及局部或全身。与纹状体受体的超敏感有关，减药或给泰必利有效。 Abnormal involuntary movement: dancing-like, athetosis-like, or myoclonic abnormal movement involve local or all over the body. This phenomenon is related to the supersensitivity of receptor in striatum, reducing dose or giving tiapride will be effective. 2） DA受体激动剂：溴隐亭、培高利特（协良行,因为其有引起心脏瓣膜与肺纤维化的副作用，2008年我国停用，替代药品为森福罗，是新一代非麦角类多巴胺受体激动剂，化学名为普拉克索。 为非麦角碱类D2和D3受体激动剂 ）。DA receptor agonist: Bromocriptine, pergolide3）儿茶酚-氧位-甲基转移酶抑制剂：托卡朋等。Catechol-o- methyltransferases: Tolcapone, etc.  4．? 外科治疗：4. Surgical therapy:1）重建性手术：体内移植多巴胺能神经元。正在研究之中。 Reconstructive procedure: dopaminergic neuron transplantation in vivo.2）破坏性手术：苍白球毁损术、丘脑毁损术、深部脑刺激Destructive procedure: globus pallidus lesion, thalamus lesion, deep brain stimulation  预后：prognosis:慢性发展（也有快发展的），无根治方法，多死于并发症（肺炎、骨折）。Usually this disease aggravates slowly( but there are fast develop case), can not be cured completely, most die of complication(pneumonia, bone fracture) 小舞蹈病 chorea minor 小舞蹈病又称风湿性舞蹈病，Sy