帕金森病患者使用多巴胺激动剂与驾驶的临床实践
Clinical practice regarding dopamine-agonist use and driving in Parkinson's disease.
作者信息
de Bie R M A, Miyasaki J, Lang A E, Fox S H
机构信息
Movement Disorders Centre, Division of Neurology University of Toronto, Toronto, Ontario, Canada.
出版信息
Can J Neurol Sci. 2007 Nov;34(4):438-42. doi: 10.1017/s0317167100007320.
BACKGROUND
Current Health Canada instructions for use of the dopamine agonists (DA), pramipexole and ropinirole, state that Parkinson's disease (PD) patients should be told not to drive. The objective was to assess neurologists' actual clinical practice concerning driving advice they give to PD patients starting a DA.
METHODS
An online survey was created consisting of 4 items regarding demographics, 5 regarding PD and driving, and 9 regarding DA use and driving. The survey was distributed to 563 neurologists.
RESULTS
In total 96 neurologists (17.9%) responded. 4.4% tell patients with PD not to drive, solely because they are taking a DA. Respondents assess the patient's tendency for excessive daytime sleepiness and sleep attacks after starting a DA more frequently than after starting other dopaminergic drugs (p < 0.001).
DISCUSSION
A minor proportion of the clinicians responding to our survey advise PD patients not to drive, solely because they use a DA. Such being the case, we propose that current Health Canada guidelines need revision.
背景
加拿大卫生部目前关于多巴胺激动剂（DA）普拉克索和罗匹尼罗使用的说明指出，应告知帕金森病（PD）患者不要开车。目的是评估神经科医生在向开始使用DA的PD患者提供驾驶建议方面的实际临床做法。
方法
创建了一项在线调查，包括4项关于人口统计学的内容、5项关于PD与驾驶的内容以及9项关于DA使用与驾驶的内容。该调查分发给了563名神经科医生。
结果
共有96名神经科医生（17.9%）做出回应。4.4%的医生仅因为患者正在服用DA就告知PD患者不要开车。与开始使用其他多巴胺能药物后相比，受访者在患者开始使用DA后更频繁地评估其白天过度嗜睡和睡眠发作的倾向（p<0.001）。
讨论
在回应我们调查的临床医生中，只有一小部分建议PD患者不要开车，仅仅是因为他们使用DA。既然如此，我们建议加拿大卫生部目前的指南需要修订。
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