帕金森病的初级治疗:2000年3月达成共识的治疗原则在北部加莱地区的应用(法国)

作     者：Simonin C. Defebvre L. Destée A. 李一明 

作者机构：Serv. Neurol. Pathol. du Mou vement H pital R. Salengro CHRU 59037 Lille Cedex France 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第5期

页      面：51-52页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：帕金森病 左旋多巴 多巴胺能药物 金刚烷胺 抗胆碱能药物 疾病严重程度 副作用发生率 

摘      要：Introduction. For Parkinson’s disease, the choice of the initial treatment is essentially between L-Dopa and dopaminergic agonists. Selegilin, anticholin ergic and amantadine can be used for subjects with moderate symptoms. The first French consensus conference, held in 2000, elaborated decision-making rules wh ich take into account both the age and disease severity. The aim of our study wa s to evaluate the impact of these recommendations on treatments prescribed for de novo parkinsonian patients in the Nord-Pas de Calais area, comparing initial prescriptions before and after the conference. Methods. Three groups of 50 patients whose diagnosis of Parkinson’s diseaseha d been establish in three periods (1985- 1992, 1993- 1999, and after July 2000 , date of the national publication of the consensus) were constituted. Results. For these 3 groups, the initial treatment complied with the 2000 recommendations for 58, 84 and 82 percent of the patients respectively. The prescriptions of ag onists increased progressively while the prescriptions of L-Dopa decreased for younger patients, in concordance with the consensus, but also for older patient s, in opposition with the recommendations, though without any increase in the incidence of side effects. The non dopaminergic treatments were almost discar ded as initial treatment. Conclusion. Prescription habits have gradually changed over the past 10 years. Changes were linked to the elaboration of the national consensus conference guidelines and to the apparent desire to decrease L-Dopa prescriptions.