Current clinical practice for Parkinson's disease among Chinese physicians, general neurologists and movement disorders specialists: a national survey.
Current clinical practice for Parkinson's disease among Chinese physicians, general neurologists and movement disorders specialists: a national survey.
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DOI：
10.1186/1471-2377-12-155
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发表时间：
2012-12-07
期刊：
影响因子：
2.6
通讯作者：
Chen SD
中科院分区：
文献类型：
--
作者：
Chen W;Chen S;Xiao Q;Wang G;Chen SD
通过全国范围内的调查，了解我国内科医生、普通神经科医生和运动障碍专科医生对帕金森病（PD）诊断和治疗的现状和选择。2010年11月至2011年7月进行了基于问卷的横断面调查。来自中国不同城市的612名医生参加了这项研究。分别有68.6%（n=420）和23.9%（n=146）的医生阅读了国家和国际指南。运动障碍专家阅读指南的比例高于内科医生和普通神经科医生（P<0.001）。分别有76.4%（n=465）和81.8%（n=498）的医生会选择标准口服左旋多巴试验和常规MRI（T1和T2）;而磁敏感加权成像（SWI）（16.1%; n=98），经颅超声（TCS）（1.8%; n=11）和功能性神经影像学检查，如单光子发射计算机断层扫描（SPECT）（10.2%; n=62）和正电子发射断层扫描（PET）（13.3%; n=81）较少用于临床实践中疑似PD患者。不同级别、不同医院、不同城市的医生除了对初诊PD患者进行初始药物选择外，对PD患者的运动并发症和非运动症状也会选择不同的药物。阅读过指南的医生在特定情况下对PD的药物选择有更好的了解。与常用的标准口服左旋多巴试验和常规MRI相比，SWI补充MRI、TCS和功能神经影像学在我国临床实践中用于诊断PD的较少。PD的诊断方法和治疗策略的选择在医生、普通神经科医生和运动障碍专家之间存在差异。指南意识明显有利于我国PD合理用药策略。
To explore current status and choices regarding diagnosis and treatment of Parkinson’s disease (PD) among physicians, general neurologists and movement disorders specialists in China via a national survey. The cross-sectional questionnaire-based survey was conducted from November, 2010 to July, 2011. Six hundreds and twelve doctors from different cities in China were recruited for this study. 68.6% (n=420) and 23.9% (n=146) of doctors have read the national and international guidelines, respectively. There was a larger proportion of movement disorders specialists reading the guidelines, in contrast to physicians and general neurologists (P<0.001). Up to 76.4% (n=465) and 81.8% (n=498) of doctors would choose standard oral levodopa test and conventional MRI(with T1 and T2), respectively; Whereas susceptibility weighed imaging(SWI)(16.1%; n=98), transcranial sonography (TCS) (1.8%; n=11) and functional neuroimaging test, such as single photon emission computed tomography(SPECT) (10.2%; n=62) and positron emission tomography(PET)(13.3%; n=81) were less used for suspected patients with PD in clinical practice. Doctors at different levels or from different hospitals and cities would choose different medication for motor complications and non-motor symptoms of patients with PD, in addition to initial drug selection for newly diagnosed PD. Doctors who had read the guidelines had significantly better knowledge of medication selections for PD under specific circumstances. Compared with commonly employed standard oral levodopa test and conventional MRI, SWI complements MRI, TCS and functional neuroimaging were less performed for diagnosis of PD in clinical practice in China. The choices of diagnostic methods and therapeutic strategy of PD vary among physicians, general neurologists and movement disorders specialists. Guideline awareness is markedly beneficial to reasonable PD medications strategy in China.
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