【作者】 崔高亮；

【导师】 石正洪；

【作者基本信息】 兰州大学 ， 神经病学， 2010， 硕士

【摘要】 第一部分运动障碍疾病Access数据库的建立目的建立运动障碍疾病Access数据库,为注册登记研究提供一个较好的平台。方法通过了解国外运动障碍疾病前瞻性队列研究现状、甘肃省运动障碍疾病医疗服务的现状及疾病临床特征,制订运动障碍疾病登记表；依据运动障碍疾病登记表的内容,启动Windows XP操作平台,进入Access2003,建立含表、查询、窗体、报表等项目的数据库。结果建成一个具有存储、数据输入输出、检索查询、统计分析等功能的运动障碍疾病数据库。结论运动障碍疾病Access数据库将在临床研究、数据管理、教学、临床经验总结等方面起着很重要的的作用。第二部分与帕金森病相关临床误诊分析目的分析与帕金森病相关的误诊病人的临床资料,以期提升对该病的认识水平,提高帕金森病的正确诊断率。方法在兰州大学第二医院运动障碍疾病Access数据库筛选32例误诊患者,结合国内外的参考文献以系统回顾的方法分析疾病误诊原因。结果特发性震颤、血管性帕金森综合、脑血管病、进行性核上性麻痹、药物性帕金森综合征、多系统萎缩等疾病易与帕金森病相混淆。结论病史采集不详细、体格检查不仔细、过分依赖辅助检查或缺少必要的辅助检查、对PD认识不足等因素与帕金森病相关误诊有关系。第三部分帕罗西汀对帕金森病伴抑郁症的疗效分析目的研究5-羟色胺再摄取抑制剂帕罗西汀治疗帕金森病伴抑郁的临床疗效。方法从兰州大学第二医院运动障碍疾病Access数据库中筛选59例帕金森病伴抑郁症患者,随机分为治疗组和对照组,治疗组30例患者,对照组29例患者。治疗组加用帕罗西汀(20mg／d),对照组加用安慰剂。评价在8周的时间内汉密尔顿抑郁量及帕金森病运动功能评分量表(MDRSPD)评分的变化。结果治疗组在2、4、8周末的汉密尔顿抑郁量评分与对照组相比并无显著变化(p>0.05),同样两组之间MDRSPD评分前后的变化也无统计学意义。结论帕罗西汀在治疗帕金森病伴抑郁症方面与对照组相比没有表现显著的治疗效果,对PD的运动症状也无明显影响。更多还原

【Abstract】 Part 1.The establishment of Movement Disorders Access database.Objective To establish a Movement Disorders Access database for providing a better platform for register research.METHODS By understanding foreign prospective cohort study status of movement disorders,the health care services status of Gansu Province and clinical features of movement disorders, developed a movement disorders registration form; According to the contents of the movement disorders registration form started Windows XP operating platform,entered Access 2003,and build a database with tables,queries, forms,reports etc.RESULTS A movement disorders database having storage,data input and output,search query,statistical analysis function etc.was established.CONCLUSION Movement Disorders database will play a very important role in clinical studies,data management,teaching,clinical experience and so on.Part 2. Parkinson’s disease-related clinical misdiagnosis analysisObjective Analysis clinical misdiagnosis data of Parkinson’s disease-related patients to update the level of awareness of the disease and improve the rate of correct diagnosis of Parkinson’s disease.METHODS Thirty-two cases misdiagnosed were screened from the movement disorders Access database of The Second Hospital of Lanzhou University Combining references at home and abroad and by the method of systematic review, analysed the causes of the misdiagnosis.RESULTS Parkinson’s disease easily confused with essential tremor,vascular parkinsonism, cerebrovascular disease,progressive supranuclear palsy,multiple system atrophy, drug-induced parkinsonism etc.CONCLUSION Not detailed history taking,careless physical examination, Over-reliance on auxiliary examination or the lack of the necessary examination, insufficient understanding of Parkinson’s disease is related to the clinical misdiagnosis.Part 3.The efficacy analysis of Paroxetine in Parkinson’s disease with depressionObjective To explore the clinical effect of Paroxetine in the patients with Parkinson disease and depression.METHODS Fifty-nine cases of PD with depression were screened from the movement disorders Access database of The Second Hospital of Lanzhou University,and randomly divided into two groups:therapy Group (30 cases),control group (29 cases).On the basic treatment, the therapy group was treated with Paroxetine (20mg/d) additionally, and control group was administered placebo. The primary outcomes were the change in the Hamilton Depression Rating Scale(HAM-D) and motor dysfunction rating scale for Parkinson’s disease(MDRSPD) in 8 weeks.RESULTS Therapy group was not superior to control group for the change in HAM-D and MDRSPD at the end of the 2nd,4th and 8th week of treatment(p> 0.05).CONCLUSION Paroxetine was not efficacious in the treatment of Parkinson disease with depression.更多还原