普拉克索治疗帕金森病患者左旋多巴诱导的运动障碍的疗效

Evaluation of the efficacy of pramipexole in the treatment of levodopa- induced dyskinesia in patients with Parkinson disease

目的评估普拉克索治疗帕金森病（PD）患者左旋多巴诱导的运动障碍（LID）的疗效。方法服用左旋多巴和麦角多巴胺激动剂治疗并出现LID的PD患者34例被随机分为2组，一组采用普拉克索加目前药物治疗（添加组，n：18），一组将麦角多巴胺激动剂替换为普拉克索进行治疗（转换组，n=16）。运动障碍的评价采用外科介入治疗总的核心评估（CAPSIT）。2组患者同时进行统-帕金森病评定量表（UPDRS）和帕金森病生活质量问卷（PDQ-39）评估。结果添加组和转换组第4、12、24周总CAPSIT分数与基线值相比均下降，差异均有统计学意义（P〈0．05或P〈0．01）；第24周与第4周比较，添加组差异无统计学意义（P〉0．05），而转换组差异有统计学意义（P〈0．05）。添加组和转换组第2、4、12、24周UPDRS第Ⅲ部分评分与基线值相比均下降，差异均有统计学意义（P〈0．05）。添加组和转换组第4、12、24周PDQ-39分数与基线值相比均下降，差异均有统计学意义（P〈0．01）。结论普拉克索可能是一种治疗LID的方法。

Objective To evaluate the efficacy of pramipexole in the treatment of levodopa - induced dyskinesia （LID） in patients with Parkinson disease （PD）. Methods PD patients were treated with levodopa and an ergot dopamine agonist and those with LID were randomized into two groups. One group was administrated with pramipexole in addition to current medications （ an addition group） , while the other group was treated with the ergot dopamine agonist in adttion to current medications （a replacement group）. The Core Assessment Program for Surgical Interventional Therapies （CAPSIT） was used to evaluate dyskinesia. The Unified Parkinson＇s Disease Rating Scale （UPDRS） and Parkinson＇s Disease Questionnaire- 39 （PDQ -39） were also adopted for evaluation. Results Both groups showed remarkably reduced CAPSIT scores on Weeks 4, 12 and 24 than the baseline （P 〈 0.05 or P 〈 0.01 ）. Statistical difference was seen as to CAPSIT score in the replacement group on Week 24, compared with the score on Week 4 （ P 〈 0.05 ）. Both groups showed remarkably reduced UPDRS - Part Ⅲ scores on Weeks 2, 4, 12 and 24 than the baseline （P 〈 0.05 ）. Both groups showed remarkably reduced PDQ - 39 scores on Weeks 4, 12 and 24 than the baseline （P 〈 0.01 ）. Conclusion Pramipexole may be effective for treatment of LID.