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帕金森病伴路易体痴呆症的诊断程序和治疗干预措施的实况调查研究。

Fact-finding survey on diagnostic procedures and therapeutic interventions for parkinsonism accompanying dementia with Lewy bodies.

机构信息

Department of Dementia and Geriatric Internal Medicine, Kanagawa Dental University Hospital, Yokosuka-shi, Japan.

Department of Emergency and General Internal Medicine, Fujita Health University Hospital, Toyoake-shi, Japan.

出版信息

Psychogeriatrics. 2019 Jul;19(4):345-354. doi: 10.1111/psyg.12408. Epub 2019 Feb 19.

DOI:10.1111/psyg.12408
PMID:30784148
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6850325/
Abstract

BACKGROUND

We performed a questionnaire survey of medical doctors engaged in the management of dementia to identify the actual status of treatment for dementia with Lewy bodies (DLB) in Japan.

METHODS

Among participating medical doctors, we selected neurologists (Group N) and psychiatrists (Group P) because these physicians are usually involved in the management of DLB patients. The two groups were compared based on their diagnosis and treatment of DLB and in particular, parkinsonism.

RESULTS

Neurological examinations and biomarker tests were less frequently performed by Group P than Group N. Antipsychotics and other psychotropics excluding anti-dementia drugs were significantly more frequently administered by Group P than Group N. The proportion of physicians who selected L-dopa as a first-line therapy for parkinsonism was significantly higher in Group N than in Group P. Despite these between-group differences, the following findings were common to the two groups: there was a discrepancy between the symptom that patients expressed the greatest desire to treat, and the awareness of physicians regarding the treatment of these symptoms; the initial agent was L-dopa; and physicians exercised caution against the occurrence of hallucinations, delusions, and other adverse drug reactions.

CONCLUSIONS

The results of the present survey offer valuable insight for the formulation of future DLB therapeutic strategies.

摘要

背景

我们对从事痴呆症管理的医生进行了问卷调查，以了解日本治疗路易体痴呆症（DLB）的实际情况。

方法

在参与的医生中，我们选择了神经科医生（N 组）和精神科医生（P 组），因为这些医生通常参与 DLB 患者的管理。我们根据两组医生对 DLB 的诊断和治疗，特别是帕金森病的诊断和治疗情况进行了比较。

结果

P 组比 N 组较少进行神经学检查和生物标志物检查。P 组比 N 组更频繁地使用抗精神病药和其他精神药物（不包括抗痴呆药物）。在帕金森病的治疗中，选择左旋多巴作为一线治疗的医生比例在 N 组显著高于 P 组。尽管存在这些组间差异，但两组有以下共同发现：患者最希望治疗的症状与医生对这些症状的治疗意识之间存在差异；初始药物为左旋多巴；医生谨慎避免出现幻觉、妄想和其他药物不良反应。

结论

本调查的结果为制定未来的 DLB 治疗策略提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/21934fe1226f/PSYG-19-345-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/72f9c98c1a36/PSYG-19-345-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/97c92be37782/PSYG-19-345-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/b4fb90e0e98a/PSYG-19-345-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/4160316ccfd4/PSYG-19-345-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/4277a84f60f3/PSYG-19-345-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/21934fe1226f/PSYG-19-345-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/72f9c98c1a36/PSYG-19-345-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/97c92be37782/PSYG-19-345-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/b4fb90e0e98a/PSYG-19-345-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/4160316ccfd4/PSYG-19-345-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/4277a84f60f3/PSYG-19-345-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e139/6850325/21934fe1226f/PSYG-19-345-g006.jpg

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