血管性帕金森患者临床表现探究结论与参考文献 发布时间:2018-03-23

"目录号: HY-14605

结论

Neuronal SignalingAutophagy-

本篇文章目录导航:

Rasagiline甲磺酸盐是MAO-B抑制剂,可作用于原发性帕金森病。

血管性帕金森综合征患者的临床研究(←点击返回查看其余5篇临床医学硕士论文) VP患者和PD患者资料及研究方法 血管性帕金森和帕金森病患者临床比较结果 血管性帕金森综合征相关因素讨论 血管性帕金森患者临床表现探究结论与参考文献

Monoamine OxidaseAutophagy

本研究经过收集数据、统计分析,得出以下结论:①VP 患者与 PD 患者相比,临床症状上更易出现肌强直、锥体束征、认知功能障碍,而 PD 患者的静止性震颤、嗅觉障碍较 VP 患者更为多见。②高龄、高血压、基底节区多发腔隙性脑梗死、同型半胱氨酸是 VP 产生的独立危险因素。本课题的创新点在于临床症状和危险因素统计分析的结合,临床症状的差异对于临床大夫在鉴别 VP 和 PD 患者具有实际的指导性意义,而危险因素对于预防 VP 的发生,延缓 VP 患者的病程进展具有参考性价值。本课题研究的不足之处在于①样本量较小,可能会造成数据的偏倚,造成结果的不确定性。下一步的研究需要增加样本量,纳入更多的 VP 组及 PD 组患者,深入研究。②由于临床工作中对于 VP 及 PD 患者的非运动症状的关注不足,所以在临床症状的分析中对非运动症状分析的不够透彻,也未对 VP 患者进行分型或做帕金森综合评分量表(Unified Parkinson’s Disease Rating Scale,UPDRS)的评定工作,故而未分析各因素与 VP 患者 UPDRS 得分之间的关系。在今后的研究中会加以关注。③随着科技发展,医学影像技术有了质的飞跃,对于 VP 的研究起了一定的推动作用,本课题对于影像资料也未进行细化分析,这是本课题下一步研究的重要补充点。④有研究显示血流动力学改变对于 VP 的产生也有一定的影响,其中纤维蛋白原、全血比粘度等也是 VP 产生的危险因素,所以对于血液指标的分析中下一步要把血液流变学指标纳入其中。目前关于 VP 的发病机制仍处于探索阶段,诊断标准尚无统一定论,影像学检查也缺乏特异性,治疗方面也存在一定的争议,仍需深入研究,以进一步服务临床。随着现代医学诊疗技术的日新月异,神经电生理在疾病诊断中的作用也日益凸显,所以我们要对 VP 的发病机制、治疗手段与方法等方面做进一步研究,以从更深层面认识该疾病,预防 VP 的发生,寻找到针对 VP 患者的有效治疗手段,这是我们未来努力的方向。

相关产品

致谢

Cycloheximide-TAK-242-LY294002-3-Methyladenine-(+)-JQ-1-SB 203580-SP600125-U0126-Enzalutamide-Actinomycin D-Olaparib-Doxorubicin hydrochloride-Dorsomorphin dihydrochloride-Mitomycin C-Bortezomib-

学海无涯,白驹过隙,三年的学习生活已接近尾声。经过一年多的筹备与撰写,我的论文终于完成。回想过去三年的求学生涯,体悟颇多,收获颇丰。现心怀感恩,对曾给予过我无私帮助的诸位良师益友,表达无限敬意。

生物活性

最先要感谢的是我的恩师林杰教授。老师工作繁忙,但依然挤出宝贵时间,指导我的学习。从论文的选题,到提纲的搭建,从初稿的写定,再到论文的修改,都倾注了老师无数的心血。三年来,老师对我关爱有加,视如己出,在学习和生活上给与我极大的支持与帮助。老师严谨的治学态度和崇高的师德、医德值得我终生追随。

Description

再来要感谢学期期间教导过我的各位带教老师。各位带教老师的悉心指导为我论文的完成打下坚实的基础。

Rasagiline Mesylate is a new MAO-B inhibitor for the treatment of idiopathic Parkinson's disease. Target: Monoamine Oxidase (MAO)-BRasagiline (N-propargyl-1-(R)-aminoindan) is a novel, highly potent irreversible monoamine oxidase (MAO)-B inhibitor, anti-Parkinsonian drug. Rasagiline is effective as monotherapy or adjunct to L-Dopa for patients with early and late Parkinson's disease (PD) [1]. Rasagiline inhibits MAO-B more potently than selegiline and has the advantage of once-daily dosing. In several large, randomized, placebo-controlled trials, rasagiline has demonstrated efficacy as monotherapy in early PD and as adjunctive therapy in advanced PD. In addition, rasagiline has been shown to have neuroprotective effects in in vitro and in vivo studies. The recently completed delayed-start ADAGIO (Attenuation of Disease Progression with Azilect Given Once-daily) trial suggests a potential disease-modifying effect for rasagiline 1 mg/day, though the clinical import of this finding has yet to be established [2]. Rasagiline has been found to be well tolerated and effective in the treatment of early PD and as adjunctive treatment in motor fluctuations. Whether rasagiline is associated with clinically significant neuroprotection (ie, disease modification) in PD is the subject of ongoing clinical trials [3].

还要感谢我的父母。异地求学,孝道难尽。父母对我的无私付出,是我强大的精神支柱。尤其是在材料的搜集阶段,父母在精神和物质上都给与了我极大的支持。在我情绪处于低谷的时候,是父母帮我顺利走出,恢复积极的心态。

Clinical Trial

最后要特别感谢我的同门学友陈红霞。她在学习和生活上给予我无私的帮助,在精神上也给予我莫大的鼓励。得挚友如是,三生有幸。

NCT01736891

在以后的人生道路中,我将常怀感人之心,满载诸位的祝福与期许,牢记自己崇高的责任与使命,将全部的精力投入到医学事业中来。

Chongqing Fortune Pharmaceutical Co., Ltd.-Beijing Bionovo Medicine Development Co., Ltd.

参考文献

Parkinson´s Disease

[1]Murrow R W, Schweiger G D, Kepes J J, et al. Parkinsonism due to a basal ganglia lacunar state: clinicopathologic correlation[J]. Neurology, 1990, 40:897-900. [2]Levin O S, Chimagomedova A S, Skripkina N A, et al. Nonmotor Symptoms in Vascular and Other Secondary Parkinsonism.[J]. International Review of Neurobiology,2017,134:1303-1334. [3]Yamanouchi H, Nagura H. Neurological Signs and Frontal White Matter Lesions in Vascular Parkinsonism A Clinicopathologic Study[J]. Stroke; a journal of cerebral circulation, 1997,28:965-9. [4]Liu W. Vascular Parkinsonism[J]. Cerebrovascular Diseases Foreign Medical Sciences, 2004,333:513-524. [5]Manosalva H A, Pio F, Jeerakathil T, et al. Vascular Parkinsonism in a Tertiary Care Stroke Prevention Clinic and the Development of a New Screening Strategy.[J]. J Stroke Cerebrovasc Dis, 2018,27:153-161. [6] Glass P G, Lees A J, Bacellar A, et al. The clinical features of pathologically confirmed vascular parkinsonism.[J]. Journal of Neurology Neurosurgery & Psychiatry, 2012, 83:1027-9. [7] Caslake R, Taylor K, Scott N, et al. Age-, and gender-specific incidence of vascular parkinsonism,progressive supranuclear palsy, and parkinsonian-type multiple system atrophy in North East Scotland: the PINE study[J]. Parkinsonism & Related Disorders, 2014, 20:834-839. [8]中华医学会神经病学分会帕金森病及运动障碍学组. 中国血管性帕金森综合征诊断与治疗专家共识[J]. 全科医学临床与教育, 2017, 50:364-367. [9]Zijlmans J C, Daniel S E, Hughes A J, et al. Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis.[J]. Movement Disorders, 2004,19:630–640. [10]Krack P, Dowsey P L, Benabid A L, et al. Ineffective subthalamic nucleus stimulation in levodopa-resistant postischemic parkinsonism.[J]. Neurology, 2000, 54:2182-4. [11] 户村则昭,玉川芳春,加藤敏郎,Vascular parkinsonism の computed tomography 所见脑と神经,1985,37“0):1007~1012. [12]Hughes A J, Daniel S E, Kilford L, et al. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.[J]. Journal of Neurology Neurosurgery &Psychiatry, 1992, 55:181. [13]中国高血压防治指南修订委员会. 中国高血压防治指南 2010[J]. 中华心血管病杂志, 2011,39:701-708. [14]陆再英, 钟南山. 内科学.第 7 版[M]. 人民卫生出版社, 2008. [15]中国成人血脂异常防治指南制订联合委员会. 中国成人血脂异常防治指南[J]. 中国实用乡村医生杂志, 2012, 19:390-419. [16]张祥建, 范振增, 张丽英. 脑出血诊疗指南[UEDBET西甲赫塔菲 ,J]. 中国全科医学, 2004, 7:1319-1320. [17]颜红兵, 柯元南. 美国冠心病诊断与治疗指南[J]. 2004. [18]Lu J, Li D, Li F, et al. Montreal cognitive assessment in detecting cognitive impairment in Chinese elderly individuals: a population-based study.[J]. Journal of Geriatric Psychiatry & Neurology, 2011, 24:184. [19]国家职业分类大典和职业资格工作委员会. 中华人民共和国职业分类大典[M]. 中国劳动社会保障出版社, 1999. [20]Zijlmans J C, Daniel S E, Hughes A J, et al. Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis[J]. Movement Disorders, 2004, 19:630–640. [21]中华医学会神经病学分会帕金森病及运动障碍学组. 中国帕金森病的诊断标准[J].中华神经科杂志, 2016, 49:268-271. [22]苏立静, 徐俊, 马甲. 血管性帕金森综合征 56 例临床分析[J]. 现代实用医学, 2016,28:448-450. [23]Benamer H T S, Grosset D G. Vascular Parkinsonism: A Clinical Review[J]. European Neurology, 2009, 61:11-15. [24]Benítezrivero S, Palomar F J, Martínrodríguez J F, et al. Abnormal sensorimotor integration correlates with cognitive profile in vascular parkinsonism.[J]. Journal of the Neurological Sciences, 2017, 377:161–166. [25]甘蓉, 张玉虎, 聂坤,等. α 突触核蛋白基因多态性与帕金森病及其认知障碍的相关性研究[J]. 中华老年心脑血管病杂志, 2012, 14:788-791. [26]Psych C C J M, Jan Petter Larsen MD PhD, Dag Aarsland MD PhD, et al. Subtypes of mild cognitive impairment in parkinson's disease: Progression to dementia[J]. Movement Disorders,2006, 21:1343-1349. [27]Sollinger A B, Goldstein F C, Lah J J, et al. Mild cognitive impairment in Parkinson’s disease:Subtypes and motor characteristics[J]. Parkinsonism & Related Disorders, 2010, 16:177. [28]Colosimo C, Morgante L, Antonini A, et al. Non-motor symptoms in atypical and secondary parkinsonism: the PRIAMO study.[J]. Journal of Neurology, 2010, 257:5-14. [29]Hoyles K, Sharma J C. Olfactory loss as a supporting feature in the diagnosis of Parkinson’s disease: a pragmatic approach[J]. Journal of Neurology, 2013, 260:2951-2958. [30]Navarro-Otano J, Gaig C, Muxi A, et al. 123I-MIBG cardiac uptake, smell identification and 123I-FP-CIT SPECT in the differential diagnosis between vascular parkinsonism and Parkinson's disease[J]. Parkinsonism & Related Disorders, 2014, 20:192-7 [31]袁晶, 王含, 万新华. 帕金森病相关认知功能障碍[J]. 中国现代神经疾病杂志, 2017, 17. [32]郭丽花, 胡如英, 龚巍巍,等. 脑卒中危险因素研究进展[J]. 中国老年学, 2017, 37. [33]赵德强. 血管性帕金森综合征与帕金森病临床特点及影像学的对比研究[J]. 南方医科大学学报, 2005, 25:868-870. [34]Gasser T. Mendelian forms of Parkinson's disease[J]. Biochimica Et Biophysica Acta, 2009,1792:587-596. [35]Foltynie T, Brayne C, Barker R A. The heterogeneity of idiopathic Parkinson's disease.[J].Journal of Neurology, 2002, 249:138-45. [36]万志荣, 商梦晴, 冯涛,等. 早发型与晚发型帕金森病患者临床异质性的研究[J]. 临床神经病学杂志, 2016, 29:178-181. [37]Frigerio R, Elbaz A, Sanft K.R,等. 帕金森病之前的受教育水平和职业:一项人群病例对照研究[J]. 世界核心医学期刊文摘:神经病学分册, 2006:36-37. [38]乔晋, 屈秋民, 韩建峰,等. 西安地区老年人帕金森病患病率调查[J]. 中国神经免疫学和神经病学杂志, 2001, 8:79-83. [39]齐江彤, 查曹兵, 陈伟良,等. 血管性帕金森综合征与帕金森病的临床特点与影像学特征比较[J]. 武警医学, 2015, 26:545-547. [40]杨娉婷, 袁洪, 王雅琴,等. 高血压前期体检人群血管内皮功能及其与脉搏波传导速度的关系[J]. 中国动脉硬化杂志, 2014, 22:472-476. [41]Chamorro A. Role of inflammation in stroke and atherothrombosis[J]. Cerebrovascular Diseases,2004, 17 Suppl 3:1. [42]孙刚顺.血管性帕金森综合征相关因素分析[J].中国老年保健医学,2011,09:52-53. [43]谈世东.血管性帕金森综合征临床研究进展[J].国际神经病学神经外科学杂志,2010,37:131-135. [44]李敏, 钱阔, 范博,等. 成人 2 型糖尿病微血管病变与血清 25-羟维生素 D 相关性探讨[J]. 糖尿病新世界, 2017, 20:44-45. [45]王新, 李春阳, 苏立平,等. 动脉粥样硬化发病机制及治疗的研究进展[J]. 实用心脑肺血管病杂志, 2017, 25:1-4. [46]Du X L, Edelstein D, Dimmeler S, et al. Hyperglycemia inhibits endothelial nitric oxide synthase activity by posttranslational modification at the Akt site.[J]. Journal of Clinical Investigation, 2001, 108:1341. [47]Morigi M, Angioletti S, Imberti B, et al. Leukocyte-endothelial interaction is augmented by high glucose concentrations and hyperglycemia in a NF-kB-dependent fashion.[J]. Journal of Clinical Investigation, 1998, 101:1905-1915. [48]高升. 糖尿病并发脑卒中的临床分析及防治[J]. 中外医学研究, 2015:105-106. [49]HanCheng Wang M D, ShihJung Cheng M D. The syndrome of acute bilateral basalganglia lesions in diabetic uremic patients[J]. Journal of Neurology, 2003, 250:948. [50]Nelson C P, Hamby S E, Danish S, et al. Genetically Determined Height and Coronary Artery Disease — NEJM[J]. New England Journal of Medicine, 2015, 372:1608-18. [51]谢诗情, 程文静, 祝骥,等. 动脉粥样硬化机制的研究进展[J]. 世界复合医学, 2016,2:85-90. [52]Barabash S,Norberg O.Strawberry extract presents antiplatelet activity by inhibition of inflammatory mediator of atherosclerosis(sP-selectin,sCD40L,RANTES,and IL-1β) and thrombus formation[J].Platelets,2015,26:224-229. [53]Sadowski M,Z bczyk M,Undas A.Coronary thrombus composition:Links with inflammation,platelet and endothelial markers[J].Atherosclerosis,2014:555-561. [54]魏岗之. 血管性帕金森综合征临床病理报告[J].中华神经科杂志,2004,43:473-474. [55]Vale TC,Caramelli P,Cardoso F. Clinicoradiological comparison be-tween vascular parkinsonism and Parkinson’s disease[J]. J NeurolNeurosurg Psychiatry,2014,86 :547-553. [56]Wright C B, Paik M C, Brown T R, et al. Total Homocysteine Is Associated With White Matter Hyperintensity Volume The Northern Manhattan Study[J]. Stroke; a journal of cerebral circulation, 2005, 36:1207-11. [57]Hara K, Onda K, Ouchi H, et al. [A case of vascular parkinsonism associated with hyperhomocysteinemia and methylenetetrahydrofolate reductase gene variant ][J].Rinsho shinkeigaku = Clinical neurology, 2016, 56:77. [58]金超, 曹中朝. 动脉粥样硬化相关因素研究进展[J]. 现代临床医学, 2016, 42:166-169. [59]Steinberg D. Atherogenesis in perspective: hypercholesterolemia and inflammation as partners in crime.[J]. Nature Medicine, 2002, 8:1211. [60]张填, 陈志斌, 王埮,等. Cys-C 在急性脑梗死并发 SIRS 致 MODS 患者中的水平变化[J]. 中风与神经疾病, 2014, 31:713-715.

November 2011

返回本篇文章目录导航↑ 相关内容

Phase 3

  • 临床医学硕士论文精选6篇
  • 胰腺癌患者术后复发危险因素研究
  • 血管性帕金森综合征患者的临床研究
  • 太极拳对脊柱康复的生物力学机制研究
  • 精液不液化症患者服用加味二陈汤的疗效
  • 急性脑出血后心脏异常患者临床分析
  • 探讨血细胞检查结果的影响及控制措施
  • 探究有效控制临床医学检验质量的措施
  • 探讨在临床医学中的CT影像诊断临床价值
  • 分析临床医学检验质量控制的影响因素及应对措
  • 临床生化检验项目中痰热清注射液的干扰情况分
  • 慢性肾病中髓过氧化物酶的作用机制

NCT01879748

Teva Pharmaceutical Industries

Parkinson's Disease

June 2013

Phase 1

NCT00203164

Teva Pharmaceutical Industries

Parkinson's Disease

May 2002

Phase 3

NCT01442610

Technische Universität Dresden-Teva Pharmaceutical Industries

Sleep Disturbances-Parkinsons's Disease

October 2011

Phase 4

NCT01652313

H. Lundbeck A/S

Parkinson's Disease

May 2012

Phase 1

NCT01786603

Richard Barohn, MD-University of Kansas Medical Center

Amyotrophic Lateral Sclerosis (ALS)

September 2012

Phase 2

NCT00936676

Teva Pharmaceutical Industries-Teva Neuroscience, Inc.-H. Lundbeck A/S

Parkinson's Disease

July 2009

NCT01168596

University of Florida

Parkinson's Disease

December 2009

Phase 4

NCT01032486

Teva Pharmaceutical Industries

Parkinson's Disease

December 2009

Phase 4

NCT00203177

Teva Pharmaceutical Industries

Parkinson's Disease

October 2001

Phase 3

NCT00755027

Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

Parkinson's Disease

September 2008

Phase 4

NCT01178047

University of Zurich-H. Lundbeck A/S

Parkinson's Disease

September 2011

Phase 4

NCT01879241

University of Ulm

Amyotrophic Lateral Sclerosis

June 2013

Phase 2

NCT01192503

University of Virginia-Teva Neuroscience, Inc.

Restless Legs Syndrome

September 2010

Phase 2-Phase 3

NCT01723228

Teva Branded Pharmaceutical Products, R&D Inc.-Teva Pharmaceutical Industries

Parkinson's Disease

November 2012

Phase 4

NCT00977665

Teva Pharmaceutical Industries-H. Lundbeck A/S

Multiple System Atrophy

December 2009

Phase 2

NCT01556165

H. Lundbeck A/S

Parkinson's Disease

April 2012

Phase 3

NCT00696215

Istanbul University

Parkinson's Disease

June 2007

Phase 4

NCT01007630

The Parkinson's Institute-Teva Neuroscience, Inc.

Parkinson's Disease

November 2009

Phase 4

NCT01232738

Yunxia Wang, MD-Western ALS Study Group-University of Kansas Medical Center

Amyotrophic Lateral Sclerosis (ALS)

December 2011

Phase 2

NCT00492336

University of Maryland-Stanley Medical Research Institute

Schizophrenia

January 2007

Phase 4

NCT01049984

Teva Neuroscience, Inc.-H. Lundbeck A/S-Teva Pharmaceutical Industries

Parkinson's Disease

December 2009

Phase 4

NCT01532141

Bial - Portela C S.A.

Parkinson Disease

November 2009

Phase 1

NCT01055379

Lundbeck Italia S.p.A.-Teva Pharmaceutical Industries

Depressive Symptoms-Parkinson's Disease

March 2010

Phase 4

NCT02278588

Thomas Guttuso-University at Buffalo

Parkinson's Disease

November 2014

NCT02068625

University Hospital Inselspital, Berne

Retinal Detachment

September 2010

Phase 4

NCT01497652

Georgetown University-Teva Neuroscience, Inc.

Parkinson's Disease

January 2012

Phase 4

NCT00955604

Teva Pharmaceutical Industries

Serotonin Syndrome

July 2009

NCT02359552

The Cleveland Clinic

Alzheimer's Disease

May 2015

Phase 2

NCT01382342

Brown University-Teva Pharmaceuticals USA

Parkinson's Disease

June 2011

Phase 4

NCT01187888

Prof. Dr. Stefan Lorenzl-Teva Pharmaceutical Industries-Ludwig-Maximilians - University of Munich

Progressive Supranuclear Palsy

January 2010

Phase 3

NCT01385735

St. Josef Hospital Bochum

Parkinson Disease

October 2011

Phase 4

NCT00256204

Teva Pharmaceutical Industries

Parkinson's Disease

November 2005

Phase 3

NCT01532128

Bial - Portela C S.A.

Parkinson Disease

November 2009

Phase 1

NCT01048229

Qualissima-H. Lundbeck A/S

Early-stage Parkinson's Disease

October 2008

Phase 4

NCT00203034

Teva Pharmaceutical Industries

Parkinson's Disease

May 2000

Phase 3

NCT00399477

Teva Neuroscience, Inc.-Teva Pharmaceutical Industries

Parkinson's Disease

October 2006

Phase 4

NCT00203138

Teva Pharmaceutical Industries

Parkinson's Disease

June 2004

Phase 3

NCT00104273

Teva Pharmaceutical Industries-Eisai Inc.

Dementia-Alzheimer's Disease

August 2004

Phase 2

NCT00203060

Teva Neuroscience, Inc.-Teva Pharmaceutical Industries

Parkinson's Disease

July 1997

Phase 3

NCT02789020

University of Florida-National Institute of Neurological Disorders and Stroke (NINDS)

Parkinson's Disease

December 2016

NCT01968460

Pharma Two B Ltd.

Parkinson's Disease

December 2013

Phase 2-Phase 3

NCT01215227

Merck Sharp & Dohme Corp.

Parkinson Disease-Idiopathic Parkinson Disease

November 2010

Phase 3

NCT00203125

Teva Pharmaceutical Industries

Parkinson's Disease

October 2000

Phase 3

生物活性,故而未解析各要素与 VP 伤者 UPD途锐S。NCT01155479

Merck Sharp & Dohme Corp.

Parkinson Disease

July 2010

Phase 3

NCT01155466

Merck Sharp & Dohme Corp.

Parkinson Disease

July 14, 2010

Phase 3

View MoreCollapse

References

[1].Weinreb, O., et al., Rasagiline: a novel anti-Parkinsonian monoamine oxidase-B inhibitor with neuroprotective activity. Prog Neurobiol, 2010. 92(3): p. 330-44.

[2].Leegwater-Kim, J. and E. Bortan, The role of rasagiline in the treatment of Parkinson's disease. Clin Interv Aging, 2010. 5: p. 149-56.

[3].Chen, J.J., D.M. Swope, and K. Dashtipour, Comprehensive review of rasagiline, a second-generation monoamine oxidase inhibitor, for the treatment of Parkinson's disease. Clin Ther, 2007. 29(9)