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迟发性运动障碍(TD)是抗精神病药物引起的一种椎体外系副反应,临床表现为不自主、不规则,无目的、刻板式的异常动作。一九五九年由Sigwald首先加以描述和命名。其发生率在0.5~56%之间,一般为20%左右。抗精神病药物是引起TD最主要的原因,70年代以来发现抗抑郁药、抗帕金森氏症药、抗癫痫药、抗组胺药、降压药、降糖药及止吐药等均可引起TD。TD发生的机制认为是:①、黑质纹状体通路突触后神经元多巴胺(DA)受体长期被阻滞后,出现“去神经增敏状态”;②、DA受体代偿性增多。由于上述两方面原因,使中枢神经系统DA能活动亢进,而乙酰硷(Ach)能相对减弱,以致DA能和Ach能平衡失调。临床上表现为TD。其表现形式为:①口舌
Tardive dyskinesia (TD) is an extrapyramidal side effect caused by antipsychotics, and its clinical manifestations are involuntary, irregular, non-purposive and stereotypical abnormalities. First described and named by Sigwald in 1959. The incidence of 0.5 to 56%, usually about 20%. Antipsychotics is the most important cause of TD. Antidepressants, anti-Parkinson’s disease drugs, antiepileptic drugs, antihistamines, antihypertensive drugs, hypoglycemic drugs and anti-emetics are all found in the 1970s TD. TD mechanism is considered: ①, nigrostriatal pathway postsynaptic neurons dopamine (DA) receptor block for a long time, the “denervated state”; ②, DA receptor compensatory increase . Due to the above two reasons, the activity of central nervous system DA hyperactivity, and acetylcholine (Ach) can be relatively weak, so DA and Ach can be balanced imbalance. Clinical manifestations of TD. Its manifestations are: ① tongue