本文選題：帕金森病 + 左旋多巴負荷試驗��； 參考：《中風(fēng)與神經(jīng)疾病雜志》2017年11期

【摘要】：目的探討左旋多巴負荷試驗診斷及鑒別診斷帕金森病的準確性,研究影響該試驗結(jié)果的相關(guān)因素。方法收集具有帕金森綜合征運動癥狀90例患者,給予美多芭125 mg/次,4次/d,連續(xù)7 d的改良左旋多巴負荷試驗,并進行1 y隨訪,記錄最終完成隨訪的85例患者的臨床資料,以試驗前后統(tǒng)一帕金森病評分量表(UPDRS)運動部分的改善率為指標(biāo),建立左旋多巴負荷試驗的ROC曲線,評估該試驗的靈敏度和特異度,應(yīng)用Logistic回歸分析引起該試驗假陽性和假陰性結(jié)果的影響因素。結(jié)果左旋多巴負荷試驗靈敏度達86.7%,特異度達76%,與隨訪后的臨床診斷Kappa值為0.58,該試驗診斷準確性可靠。HY分級、服用多巴胺能制劑時間是引起試驗假陰性的獨立影響因素(P0.05);病程是引起試驗假陽性的獨立影響因素(P0.05)。結(jié)論改良的左旋多巴負荷試驗對帕金森病診斷的準確性高;帕金森病患者的疾病程度輕、服用多巴胺能制劑時間長對左旋多巴負荷試驗的反應(yīng)不明顯;部分非帕金森綜合征患者在疾病早期具有一定的多巴胺能反應(yīng)性。
[Abstract]:Objective to investigate the accuracy of Levodopa stress test in the diagnosis and differential diagnosis of Parkinson's disease and to study the related factors affecting the results of the test.Methods 90 patients with motor symptoms of Parkinson's syndrome were treated with modified L-dopa load test for 7 days with medopa 125 mg/ / d for 7 days. All patients were followed up for 1 y. The clinical data of 85 patients who were finally followed up were recorded.The ROC curve of the left dopa load test was established to evaluate the sensitivity and specificity of the exercise part of the unified Parkinson's disease scale before and after the test.Logistic regression analysis was used to analyze the factors influencing the false positive and false negative results of the test.Results the sensitivity and specificity of the levodopa stress test were 86.7 and 760.The diagnostic Kappa value of the test was 0.58 and the diagnostic accuracy of the test was reliable.The time of taking dopaminergic preparation was the independent influencing factor of false negative test and the course of disease was the independent influencing factor of false positive test.Conclusion the improved levodopa stress test has a high accuracy in the diagnosis of Parkinson's disease, and the patients with Parkinson's disease have a mild degree of disease and a long period of time taken by dopaminergic agents has no obvious response to the levodopa stress test.Some patients with non-Parkinson's syndrome have dopaminergic reactivity at the early stage of the disease.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R742.5

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