Restless leg syndrome: is it a real problem?
Restless leg syndrome: is it a real problem?
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DOI：
10.2147/tcrm.2006.2.4.465
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发表时间：
2006-12-01
影响因子：
2.8
通讯作者：
O'Keeffe, Shaun T
中科院分区：
文献类型：
--
作者：
Cotter, Paul E;O'Keeffe, Shaun T
不宁腿综合征(RLS)是一种常见的疾病，经常被忽视、误诊和处理不善。它的特点是腿部深处在休息时产生不适感，迫使人移动；症状在晚上最严重，睡眠障碍很常见。在西方国家，RLS发生在7%-11%的人口中，许多这样的人会经历令人烦恼的症状。在多达三分之二的患者中，原发RLS是家族性的。RLS也可能继发于许多情况，包括缺铁、妊娠和终末期肾功能衰竭，或许还有神经病变。继发性RLS在晚年第一次出现的患者中最为常见。RLS的发病机制可能涉及全身性或脑性缺铁与大脑皮层下多巴胺能神经传递受损的相互作用。RLS对多巴胺能疗法非常敏感。对于长期使用左旋多巴治疗的患者，清晨RLS症状反弹和一天早些时候出现严重症状(增强)是有问题的。因此，多巴胺激动剂已成为一线治疗药物。抗惊厥药物和阿片类药物对某些患者有帮助。在二级RLS的管理中，尽可能纠正潜在问题是重要的。
Restless legs syndrome (RLS) is a common condition that is frequently unrecognized, misdiagnosed and poorly managed. It is characterized by uncomfortable sensations deep in the legs developing at rest that compel the person to move; symptoms are worst at night and sleep disturbance is common. RLS occurs in 7%-11% of the population in Western countries, and many such people experience troublesome symptoms. Primary RLS is familial in up to two thirds of patients. RLS may also be secondary to a number of conditions including iron deficiency, pregnancy and end-stage renal failure and, perhaps, neuropathy. Secondary RLS is most common in those presenting for the first time in later life. The pathogenesis of RLS probably involves the interplay of systemic or brain iron deficiency and impaired dopaminergic neurotransmission in the subcortex of the brain. RLS is very responsive to dopaminergic therapies. Rebound of RLS symptoms during the early morning and development of severe symptoms earlier in the day (augmentation) are problematic in those treated for a prolonged period with levodopa. Consequently, dopamine agonists have become first line treatment. Anti-convulsant medications and opioids are helpful in some patients. Correction of underlying problem wherever possible is important in the management of secondary RLS.