氯氮平治疗帕金森病患者中左旋多巴诱导的异动症

Suppression of Levodopa-induced Dyskinesia in Parkinson's Disease

目的 :探讨氯氮平治疗帕金森病 (PD)患者中左旋多巴诱导的异动症 (LID)的疗效、合适剂量、不良反应。方法 :对 12例出现LID的PD患者添加氯氮平治疗 ,治疗前后进行UPDRS的异动症评分、运动功能评分和血白细胞的计数。结果 :氯氮平 (5 0± 5 1)mg显著改善了 91 7% (11/12 )PD患者的异动症状 ,治疗前异动症评分为 3 4± 0 7,治疗后为 1 6± 1 3 ,差异显著 (P <0 0 1)。治疗过程中无患者出现运动功能的恶化和血白细胞的减少。结论 :小剂量 (5 0mg)氯氮平能有效改善PD患者的LID 。

Aim:To evaluate the efficacy,optimal doses and side effects of clozapine for treating levodopa induced dyskinesia in parkinsonian patients.Methods:Increasing daily doses of clozapine were given to 12 patients with Parkinson's disease and levodopa induced dyskinesia.The severity of dyskinesia and parkinsonian motor disability were measured respectively by using UPDRS score and WBC counts were moniored before and after the clozapine treatment.Results:Clozapine reduced the levodopa induced dyskinesia in 11 out of 12 patients(91 7%).There is a significant improvement of the dyskinesia after clozapine treatment at daily doses of 50±51 mg,without aggravation of parkinsonian motor disability and changes of WBC counts.Conclusion:Clozapine at daily doses of 50 mg is safely to be used and significantly improves levodopa induced dyskinesia without worsening parkinsonian motor disability.