社團法人臺灣臨床藥學會

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【綜述】帕金森氏症的新知
Update on Parkinson’s Disease
帕金森氏症、流行病學、病理變化、診斷、治療方法、Parkinson’s disease, epidemiology, pathogenesis, diagnosis, updating treatments.
賴永昌Lai, Yung-Chang1 、陳玉蘭Chen, Yu-Lan*1 、賴婕瑄Lai, Jie-Shiuan2
1台灣中山醫學大學附設醫院藥劑科 、2台灣中山醫學大學附設醫院藥劑科藥物諮詢組 組長
    帕金森氏症(Parkinson’s disease)是一種進行性的腦部神經元退化疾病。目前已知此疾病與基底神經節中之多巴胺(dopamine)濃度耗盡有關。其主要臨床症狀包括運動遲緩、姿勢平衡異常、肌肉僵硬以及顫抖等。
從流行病學的角度來看,帕金森氏症盛行於世界各國的老年人族群。平均發病年齡為55至60歲;此外70至80歲之族群罹患率會明顯增加。在台灣地區,此疾病的發生率與西方國家相似:每十萬人就有130.1人罹患帕金森氏症。此數據顯示或許「環境因素」在疾病的病理變化上佔有相當重要的角色。由於帕金森氏症影響相當多的患者及其生活品質,因而被認定為現今社會重要的神經退化性疾病之一。
    隨著新藥物的研發與生化科技之進步,社會大眾對於帕金森氏症的認識亦有了明顯的改變。因此身為醫療團隊的一份子,對於此疾病的新知有全盤式的了解更顯得重要。本文章將探討有關帕金森氏症之遺傳因子、環境因素、病理變化、診斷、治療方法以及相關的治療藥物。

    Parkinson’s disease (PD) is a progressive and degenerative disorder of the brain, which is associated with depletion of dopamine levels within the basal ganglia. Its clinical manifestations include bradykinesia, postural imbalance, muscle rigidity and tremor. From the aspect of epidemiology, Parkinson’s disease is prevalent worldwide in the elderly. The incidence rises significantly in the age of seventies and eighties, and the mean age of onset is around 55 to 60 years. In Taiwan, the prevalence rate of PD for all age groups is 130.1 per 100,000 population, which is similar to those in Western countries. This may indicate that environmental factors are more important in the pathogenesis of Parkinson’s disease. Due to the fact that the disease affects huge numbers of people and their quality of life, it is considered as one of the most important neuro-degenerative disorders in our society.
    With the development of new medicines and advances in biotechnology, people’s knowledge towards Parkinson’s disease has significant changes. A general understanding of Parkinson’s disease is crucial to primary health professionals practicing in medicines. Hence, this essay focuses on updating studies on causes of Parkinson’s disease in terms of genetic and environmental factors, pathological changes, diagnosis and treatments of Parkinson’s disease. A discussion on medication of Parkinson’s disease, in terms of advantages and disadvantages, is also included.
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