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</tbody></table> <table id="bjtj" width="960" border="0" align="center" cellpadding="0" cellspacing="0" style="margin:2px 0 2px 0"> <tbody><tr> <td width="100%" height="25" align="left" valign="middle" background="/images/bt.jpg" style="padding-left:110px; background-repeat:no-repeat;font-size:12px;">  </td> </tr> </tbody></table> <table id="wz" width="960" border="0" cellspacing="0" cellpadding="0"> <tbody><tr> <td align="left">您當(dāng)前的位置--><a href="/index.shtml">首頁</a>--><a href='/jkzx/index.shtml'>健康在線</a></td> </tr> </tbody></table> <table id="content" width="960" border="0" cellspacing="0" cellpadding="0"> <tbody><tr> <td id="con_left" align="left" valign="top"> <table id="ctl00_ContentPlaceHolder1_DataList1" cellspacing="0" border="0" style="border-collapse:collapse;"> <tbody><tr> <td> <table width="705" border="0" cellpadding="0" cellspacing="0" class="bor_news"> <tbody><tr> <td align="center" class="black_titnews pad10">新療法或?yàn)榕两鹕』颊邘硇孪Ｍ?/td> </tr> <tr> <td align="center"><table width="80%" border="0" cellpadding="0" cellspacing="0" class="bor_news1"> <tbody><tr> <td class="time_placeholder" width="41%" align="left" valign="bottom" class="pad1 pad10"></td> <td class="time_placeholder" width="25%" align="left" valign="bottom" class="pad1 pad10"></td> <td id="time" width="34%" align="left" valign="bottom" class="pad1 pad10">發(fā)布時(shí)間:2023年04月11日 14:12</td> </tr> </tbody></table></td> </tr> <tr style="display:none;"> <td align="center" class="dis1 pad1 pad2 pad10 black_link_news"> <img id="ctl00_ContentPlaceHolder1_DataList1_ctl00_Image1" border="0" src="/images/zwtp.jpg" style="height:130px;width:180px;border-width:0px;"> </td> </tr> <tr> <td align="left" class="dis1 pad1 pad2 pad10 black_link_news"> <p style="text-align:center;"></p> <p style="text-align:center;"></p> <p> <p>　　干細(xì)胞治療、免疫療法、納米材料制劑治療</p> <p>　　雖然帕金森病目前無法完全治愈，但可以通過藥物、手術(shù)、康復(fù)、心理疏導(dǎo)獲得比較好的療效。帕金森病的主要療法是藥物治療，目前常用的6類藥物為左旋多巴類制劑、多巴胺受體激動(dòng)劑等。除了藥物、手術(shù)治療外，目前科研人員也在探索一些帕金森病的新療法，如免疫療法、干細(xì)胞治療、納米材料制劑治療等。</p> <p>　　4月11日是第27個(gè)世界帕金森病日。帕金森病是一種運(yùn)動(dòng)障礙疾病，全球目前約有600萬名帕金森病患者。</p> <p>　　在我國，帕金森病的平均患病年齡為60歲，患者已超300萬人。其中，65歲以上老年人發(fā)病率為1.7%。帕金森病已成為繼腫瘤、心腦血管疾病之后的中老年常見疾病。此外，中青年型帕金森病患者已占帕金森病患病總?cè)藬?shù)的5%—10%。</p> <p>　　對于帕金森病，目前我國診療現(xiàn)狀如何？相關(guān)最新研究有哪些？未來還有怎樣的新療法？科技日報(bào)記者就此采訪了相關(guān)專家。</p> <p>　　藥物治療存在“蜜月期”</p> <p>　　“帕金森病患者中腦黑質(zhì)區(qū)多巴胺神經(jīng)元退化明顯�！北本┐髮W(xué)第一醫(yī)院神經(jīng)內(nèi)科主任醫(yī)師孫永安向記者介紹，多巴胺神經(jīng)元參與感官知覺調(diào)節(jié)及人體運(yùn)動(dòng)協(xié)調(diào)�，F(xiàn)有研究認(rèn)為，帕金森病是由黑質(zhì)多巴胺能神經(jīng)元損傷或退化，導(dǎo)致多巴胺分泌減少，進(jìn)而引起的疾病。</p> <p>　　記者了解到，引起帕金森病的因素有遺傳、老齡化、腦血管疾病、腦外傷等，而帕金森病患者呈年輕化趨勢還與環(huán)境毒素、毒品、壓力應(yīng)激等多因素有關(guān)。</p> <p>　　雖然帕金森病目前無法完全治愈，但可以通過藥物、手術(shù)、康復(fù)、心理疏導(dǎo)獲得比較好的療效。</p> <p>　　帕金森病的主要療法是藥物治療，目前常用6類藥物：左旋多巴類制劑、多巴胺受體激動(dòng)劑、COMT抑制劑、抗膽堿能藥、單胺氧化酶-B抑制劑、金剛烷胺�！斑@些藥物的作用要么是補(bǔ)充多巴胺，要么是減少多巴胺的代謝，要么是增加多巴胺的利用效率。”首都醫(yī)科大學(xué)北京友誼醫(yī)院神經(jīng)內(nèi)科副主任醫(yī)師張麗燕此前接受記者采訪時(shí)表示。</p> <p>　　不過帕金森病是神經(jīng)退行性疾病，通�；颊哂盟�4—5年后藥物療效就沒有最初那么好了，這四五年就是帕金森病藥物治療的“蜜月期”。</p> <p>　　孫永安告訴記者，正常腦部生理性分泌多巴胺是24小時(shí)緩慢釋放，而外源性補(bǔ)充多巴胺呈“脈沖式”刺激，例如左旋多巴每天需服用3—4次。早期治療階段，患者多巴胺受體對于多巴胺較敏感，其癥狀波動(dòng)不大。但長期大劑量使用多巴胺，受體敏感性會(huì)下降，出現(xiàn)療效持續(xù)時(shí)間短(劑末現(xiàn)象)、療效不穩(wěn)定(開關(guān)現(xiàn)象)等副作用。</p> <p>　　對于帕金森病的用藥，孫永安表示，提倡遵循“不求全效、細(xì)水長流”的原則，即從小量開始服用，緩解癥狀到不影響生活即可。</p> <p>　　帕金森病患病歷程可達(dá)20—30年，早期患者建議以藥物結(jié)合康復(fù)鍛煉為主，部分中晚期患者可輔以手術(shù)治療。相比于神經(jīng)核毀損手術(shù)，腦深部電刺激手術(shù)通過微創(chuàng)方式給患者植入腦起搏器來實(shí)現(xiàn)神經(jīng)調(diào)控，可達(dá)到減輕和控制震顫、僵直等癥狀的目的。這種技術(shù)在國內(nèi)及歐美各國已經(jīng)較為成熟。</p> <p>　　創(chuàng)新研究層出不窮</p> <p>　　帕金森病早期容易誤診與漏診，尋找提高疾病診斷效能的標(biāo)志物成為該領(lǐng)域的一大研究熱點(diǎn)。</p> <p>　　2022年9月，中南大學(xué)湘雅醫(yī)院的研究團(tuán)隊(duì)發(fā)現(xiàn)可通過實(shí)驗(yàn)犬嗅辨帕金森病的新方法，證實(shí)帕金森病患者的確具有特殊體味，這是世界上首次報(bào)道證實(shí)利用實(shí)驗(yàn)動(dòng)物輔助診斷人類帕金森病。目前，該團(tuán)隊(duì)正研究其具體機(jī)制，加快臨床轉(zhuǎn)化應(yīng)用。</p> <p>　　2022年11月底，瑞士蘇黎世聯(lián)邦理工學(xué)院的科學(xué)家們發(fā)現(xiàn)，健康人士和帕金森病患者脊髓液中一組蛋白質(zhì)的形狀不同，這76種蛋白質(zhì)有望用作檢測帕金森病的新型生物標(biāo)記物。該團(tuán)隊(duì)計(jì)劃對已發(fā)現(xiàn)的標(biāo)記物進(jìn)行徹底檢測和驗(yàn)證，評估其檢測帕金森病的效率等。</p> <p>　　除了藥物、手術(shù)治療外，目前科研人員也在探索一些帕金森病的新療法，如免疫療法、干細(xì)胞治療、納米材料制劑治療等。</p> <p>　　“目前比較受關(guān)注的是免疫療法�！睂O永安解釋，當(dāng)異常的α-突觸核蛋白聚集，就會(huì)破壞腦細(xì)胞的內(nèi)部運(yùn)作，導(dǎo)致帕金森病等由大腦損傷引發(fā)的認(rèn)知障礙�？蒲腥藛T通過針對α-突觸核蛋白制備疫苗或單克隆抗體對該病進(jìn)行靶向治療。但目前免疫療法成本較高，而且脫靶率很高，因此并沒有達(dá)到對帕金森病很好的治療效果。</p> <p>　　國內(nèi)外科研人員還在嘗試用干細(xì)胞治療帕金森病。比如，2022年12月，昆明理工大學(xué)靈長類轉(zhuǎn)化醫(yī)學(xué)研究院的科研團(tuán)隊(duì)，開發(fā)出用于帕金森病治療的可持久穩(wěn)定分泌多巴胺神經(jīng)遞質(zhì)的基因工程化間充質(zhì)干細(xì)胞，其可快速恢復(fù)急性和慢性帕金森病猴模型的運(yùn)動(dòng)和非運(yùn)動(dòng)障礙缺陷。</p> <p>　　值得關(guān)注的是，納米材料不僅是遞送藥物的良好載體，一些納米材料還表現(xiàn)出神經(jīng)保護(hù)作用。2022年8月，南開大學(xué)藥學(xué)院薛雪教授團(tuán)隊(duì)聯(lián)合中國科學(xué)院相關(guān)團(tuán)隊(duì)，把納米材料P-sheet作為藥物，通過一定的機(jī)制作用于細(xì)胞，抑制神經(jīng)元喪失，有效緩解了帕金森病運(yùn)動(dòng)功能障礙。</p> <p>　　帕金森病診療還需更加精準(zhǔn)</p> <p>　　未來，帕金森病診療還面臨哪些挑戰(zhàn)？</p> <p>　　專家指出，目前尚缺乏對帕金森病早期精準(zhǔn)診斷的有效手段。而早發(fā)現(xiàn)、早治療有利于保護(hù)大腦中的多巴胺神經(jīng)元，延緩病情進(jìn)展。據(jù)報(bào)道，研究顯示，在上海這樣的一線城市，帕金森病患者從起病至確診所需時(shí)程的中位時(shí)間為10個(gè)月，在此過程中誤診率達(dá)23.53%。</p> <p>　　此外，雖然針對帕金森病的治療取得了很多進(jìn)展，但還存在一些難題影響疾病的治療效果。</p> <p>　　薛雪表示，對于腦部疾病的治療，血腦屏障是一道繞不過的“坎”。血腦屏障的存在，阻止了絕大部分小分子和大分子的轉(zhuǎn)移，目前已有藥物的血腦屏障穿過率不足5%，嚴(yán)重限制了神經(jīng)中樞系統(tǒng)疾病的治療。</p> <p>　　要想解決這個(gè)問題，一方面可以從增加血腦屏障的通過率入手，另一方面需要增強(qiáng)藥物的靶向性，使藥物可以特異性地作用于腦細(xì)胞。</p> <p>　　在增加血腦屏障通過率和提高特異性這兩方面，納米材料都具有廣闊前景。在薛雪團(tuán)隊(duì)的研究中，科研人員通過在聚乙二醇鏈上連接一些可以靶向腦部的分子伴侶或者配體，同時(shí)通過調(diào)節(jié)納米材料的大小和表面修飾來增加血腦屏障的通過率。</p> <p>　　對帕金森病患者來說，未來在腦部植入一個(gè)神經(jīng)芯片，協(xié)同對抗令人困擾的震顫發(fā)作，或許是一種可行的選擇。2023年初，瑞士洛桑聯(lián)邦理工學(xué)院研究人員將低功耗芯片設(shè)計(jì)、機(jī)器學(xué)習(xí)算法和柔性植入式電極相結(jié)合，制作出一種神經(jīng)芯片，可識(shí)別和抑制包括帕金森病在內(nèi)的多種神經(jīng)系統(tǒng)疾病癥狀。</p></p> <p> </p> <p>（來源：科技日報(bào)）</p> <p style="text-align:right;">(編輯：王思博)</p> <div style="text-align: center; "><img src="/9/2021-05-31/U435P916T9D412F261DT20210601101353.jpg"width=550; height=389;></div> </td> </tr> </tbody></table> </td> </tr> </tbody></table> </td> <td id="con_right" align="right" valign="top"> <table width="249" border="0" cellspacing="0" cellpadding="0"> <tbody><tr> <td width="249" height="35" background="/images/bg_titzxs.jpg"><table width="249" border="0" cellspacing="0" cellpadding="0"> <tbody><tr> <td width="20%" align="center" class="red_tit pad1"><a href="/zxsjzzl/index.shtml">更多</a></td> <td width="80%" align="left" class="gray"><a href="/zxsjzzl/index.shtml"></a></td> </tr> </tbody></table></td> </tr> <tr> <td height="220" 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