多巴丝肼联合盐酸普拉克索对老年中晚期PD患者血清中Hcy浓度的影响及其临床意义

Treatment effect and impact on Hcy concentration of benserazide and senflor treating elderly patients with middle-late PD

目的：探讨多巴丝肼联合森福罗（盐酸普拉克索）治疗老年中晚期帕金森病的效果及对同型半胱氨酸（homocysteine，Hcy）浓度的影响。方法回顾性分析2010年3月～2013年5月经我院收治的老年中晚期PD患者103例，根据用药方案分为单纯组和联合组，其中单纯组给予多巴丝肼治疗，联合组给予多巴丝肼片和森福罗（盐酸普拉克索片）治疗。临床疗效采用UPDRS评分评定，生活质量变化采用PDQ-39评分评定。并于治疗前及治疗2、6个月后检测两组患者血浆Hcy水平。结果治疗6个月后，联合组患者总有效率高达94.44%，与单纯组的69.39%比较，差异有统计学意义（P〈0.05）。两组治疗后PDQ-39评分均明显降低，但联合组患者PDQ-39评分显著低于单纯组（P〈0.05）。治疗6个月后单纯组血浆Hcy水平明显升高，而与联合组比较无显著性差异（P〉0.05）。结论多巴丝肼联合森福罗治疗老年中晚期帕金森病能显著提高治疗效果，改善患者的生活质量，且不加重多巴丝肼造成的高Hcy血症，值得临床作进一步推广。

Objective To investigate the treatment effect and impact on plasma homocysteine （Hcy） concentration of benserazide and senflor treating elderly patients with middle-late Parkinson＆#39;s disease （PD）. Methods 103 elderly pa-tients with middle-late PD were retrospectively analyzed in our hospital from March 2010 to May 2013,which divided into pure group and combined group according to treating method. Pure group was given dobutamine silk hydrazine treatment,combined group was given benserazide and senflor （pramipexole hydrochloride） treatment. Clinical efficacy was evaluated by UPDRS score and quality of life changes were rated by PDQ-39. Hcy before and after 6 months treatment of two groups was detected. Results After treated with 2,6 months, effective rate of the combined group to-tal was as high as 94.44%, was higher than the 69.39% of pure group, and the difference was statistically significant（P〈0.05）. PDQ-39 grading of the two groups after treatment were significantly lowered, and the PDQ-39 score of combined group was significantly lower than that of the pure group（P〈0 . 05）. The level of Hcy after treated with Benserazide for six months increased significantly, while Hcy levels had no further increase after treated with senflor. The level of Hcy in combined group after 6 months treatment was higher,without significant difference combined with the pure group （P〉0.05）. Conclusion Benserazide combined senflor treating middle-late PD can significantly improve the effect of treatment, improve the patient＆#39;s quality of life, and do not increase high Hcy levels which is caused by benserazide,it＆#39;s worth of further clinical promotion.