P型和C型多系统萎缩的急性多巴反应性研究

The Difference of Acute Levodopa Responsiveness between the MSA-P and MSA-C

目的研究P型和C型多系统萎缩(MSA)对左旋多巴的急性反应性。方法对P型MSA患者18例、C型MSA患者13例和帕金森病(PD)患者23例行急性阶梯式左旋多巴试验,药物剂量依次为左旋多巴/苄丝肼50 mg/12.5 mg1、00 mg/25 mg1、50 mg/37.5 mg、200 mg/50 mg和300 mg/75 mg。以UPDRS运动分量表作为评价标准,计算UPDRS运动评分平均最大改善率并比较各组患者的多巴反应性。结果左旋多巴/苄丝肼剂量为100 mg/25 mg、150 mg/37.5 mg、200 mg/50 mg和300 mg/75 mg时,MSA-P型组和MSA-C型组的UPDRS运动评分平均最大改善率均显著低于PD组,MSA-P型组高于MSA-C型组。MSA-P型组患者随服用左旋多巴/苄丝肼剂量增加UPDRS评分平均最大改善率呈逐渐增高趋势,而MSA-C型不同剂量间UPDRS评分平均最大改善率差异无统计学意义。结论MSA-P型组具有剂量依赖的急性多巴反应性,而MSA-C型组基本无急性多巴反应性。

Objective To investigate the difference of acute levodopa responsiveness between the multiple system atrophy-P（MSA-P） and the multiple system atrophy-C（MSA-C）. Methods 18 patients with MSA-P, 13 patients with MSA-C and 23 patients with Parkinson disease （PD） were undergone the acute consecutive levodopa challenge test with five dosage of madpor from 50 mg/12.5 mg,100 mg/25 mg,150 mg/37.5 mg, 200 mg/50 mg to 300 mg/75 mg . The best improvement of Unified Parkinsion disease rating scale （UPDRS） motor subscale scores after administration of levodopa was compared between MSA-P .group, MSA-C group and PD group respectively at same dosage. The change of improvement of UPDRS motor subscale score at five dosage was also compared in. the same group. Results The best improvement, of UPDRS motor subscale in two MSA subgroup was lower prominently than that of PD group. Meanwhile the MSA-P group showed more improvement of UPDRS motor Subscale scores than that of the MSA-C group. In MSA-P group the improvement of UPDRS motor subscale scores improved significantly along with increasing of levodopa dosage. But in MSA-C group the improvement of UPDRS motor subscale scores didn＇t change significantly at consecutive dosage. Conclusions MSA-P has moderate to mild acute dopa responsiveness with dosage dependence while MSA-C almost hasn＇t any acute dopa responsiveness.