摘要
目的探讨引起药源性帕金森综合征的药物种类及作用机制,以促进临床实践中的合理用药。方法检索建库至2025年4月中文医药卫生期刊报道的药源性帕金森综合征病例547例,对患者的年龄、性别、药物分布、给药途径、药源性帕金森综合征症状出现时间和转归等相关资料进行回顾性统计分析。结果在所有547例患者中,有194例男性和353例女性,平均年龄为61.5岁。引起药源性帕金森综合征的药物共涉及14类43种,其中钙通道阻滞剂的发病率最高,占46.80%;其次为抗精神病药,占20.11%;引起药源性帕金森综合征最多的药物品种为氟桂利嗪(247例)。547例患者中,476例接受了单药治疗,71例接受了联合用药治疗。多数药物以正常剂量、正常途经给药,其中口服给药占绝大多数,其余为静脉滴注、静脉注射及肌内注射。药源性帕金森综合征发生时间最短是在服药2 h后,最长是在用药10余年后。临床主要表现包括行动迟缓、肌强直、肢体震颤、面具脸。332例采取了停用原因药措施,未作特殊处理,其中1例是在停原因药24 h后症状消失,326例症状在6 d~1年3个月内逐渐缓解,而另外5例患者症状改善不明显;215例患者停用原因药并进行对症治疗,1例患者在2 h后症状消失,201例患者症状得到缓解,另外13例患者症状未能缓解。结论在临床工作中,应该高度重视药源性帕金森综合征的发生,并且要熟悉致病药物的特性,以便及早发现并采取有效的治疗措施。
Objective To discuss the drug types and mechanisms of drugs that cause drug-induced parkinsonism,so as to pro-mote rational drug use in clinical practice.Methods A total of 547 cases of drug-induced parkinsonism reported in Chinese medical and health journals from the establishment of the database to April 2025 were retrieved,and the relevant data of patients'age,gender,drug distribution,route of administration,onset time and outcome of drug-induced parkinsonism were retrospectively analyzed.Results Among the 547 patients,194 were male and 353 were female,with an average age of 61.5 years.There were 43 kinds of drugs in 14 classes,among which calcium channel blockers had the highest incidence,accounting for 46.80%.Antipsychotics followed,account-ing for 20.11%;Flunarizine caused the most drug-induced parkinsonism(247 cases).Among 547 patients,476 were administered a-lone and 71 were administered in combination.Most of the drugs were administered in accordance with normal dosage and normal route,with oral administration accounting for the vast majority,and the rest were intravenous drip,intravenous injection and intramus-cular injection.The shortest onset time of drug-induced parkinsonism was 2 hours after taking the drug,and the longest was more than 10 years after taking the drug.Clinical manifestations include bradykinesia,muscle rigidity,limb tremor,and mask face.332 cases were taken to stop the cause drug without special treatment,among which 1 case showed disappearance of symptoms at 24 hours after stopping the cause drug,326 cases gradually relieved within 6 days to 1 year and 3 months,and the other 5 patients had no obvious im-provement in symptoms.215 patients stopped taking the cause drug and were treated symptomatically,1 patient's symptoms disappeared after 2 hours,201 patients'symptoms improved,and the remaining 13 patients'symptoms did not improve.Conclusion In clinical work,we should attach great importance to the occurrence of drug-induced parkinsonism,and be familiar with the characteristics of pathogen-ic drugs,so as to detect early and take effective treatment measures.
作者
彭秋燕
PENG Qiuyan(Department of Pharmacy,Haihe Hospital,Tianjin University,Tianjin 300350,China)
出处
《天津药学》
2025年第7期874-878,共5页
Tianjin Pharmacy
