治疗中枢神经系统退行性疾的病药教学文案.ppt

治疔中枢神经系统 银行性疾病药  Normal Substantia C nigra striatum Schematic representation of the Dopamine sequence or neurons involved in Acetyl GABa Parkinsonism choline Top: Dopaminergic neurons(color) originating in the substantia nigra Parkinsonism normally inhibit the GABAergic output from the striatum, whereas cholinergic neurons (gray)exert an oo excitatory effect Middle: In parkinsonism there is a selective lossof Huntingtons disease dopaminergic neurons (dashed, color) 0-  Muhammad Ali, the greatest boxer  ①  Symptoms of Parkinsons disease Tremor at rest Brady kinesi Slowness of movements Difficulty initiating movements Rigidity Parkinsonian gait-short, rapid steps Small handwriting Weight loss Blank facial expression Less eye blinking Bradykinesia of facial muscles  Anti-Parkinsons disease drugs 帕金森氏病( Parison s disease,PD,震颤麻痹) 常见的严重慢性神经系统疾病,与锥体外系病变有关 临床分三种类型:原发型、动脉硬化老年型和脑炎后遗症型 Parkonsonisan syndrome(帕金森氏综合征) 锥体外系反应:由某些药物(利血平,部分抗精神病 药)引起  Basal gang a Thalamus Substantia nigra  Cllinical situation四组征候 (1)肌肉可逆性强直或僵硬 (2)运动障碍 (3)震颤 (4)姿势异常 PD主要病变部位:基底神经节。黑质致密带中央部 分受损较重,神经细胞(尤其是黑色素细胞)变性 或减少,甚至完全消失 苍白球、丘脑下部也受损  锥体外系的重要神经通路 (1)黑质-纹状体通路(DA); DA神经元主要位于黑质,此处有大量DA神经走向纹状体(尾核 和壳核)和中央杏仁核,形成黑质-纹状体束,中枢神经系统 的DA约80%集中于该处 (2)苍白球→大脑皮质运动区、运动前区通路 (Ach) (3)r氨基丁酸通路(GABA) (4)其它:5-HT、甲硫脑啡肽、β内啡肽等  侧脑室 尾核 丘脑 第三脑室 壳核 黑质一纹次体多 苍白球 巴胺能神经通路 质