普拉克索联合恩他卡朋对帕金森病患者血清同型半胱氨酸、尿酸水平及神经功能的影响

Effects of pramipexole combined with entacapone on serum levels of homocysteine and uric acid and neurological function in the patients with Parkinson’s disease

目的:研究普拉克索联合恩他卡朋对帕金森病患者血清同型半胱氨酸(Hcy)、尿酸(UA)水平及神经功能的影响。方法:纳入苏州市立医院2016年2月-2020年2月收治的帕金森病患者80例,按照随机数字表法分为两组,每组40例。对照组在使用多巴丝肼基础上联合恩他卡朋治疗,观察组在对照组治疗方案基础上加用普拉克索治疗,两组患者均治疗6周。分别在治疗前和治疗6周后测定血清Hcy和UA水平,并比较两组患者的临床疗效。采用蒙特利尔认知评估量表(MoCA)和简易智能精神状态检查量表(MMSE)评价两组患者的神经功能。经帕金森病统一评定量表(UPDRS)分析患者肢体运动功能的变化,并观察两组患者药品不良反应(ADRs)发生率。结果:观察组总有效率为92.5%,显著高于对照组的75.0%(P<0.05)。两组患者治疗后血清Hcy水平显著低于治疗前,血清UA水平显著高于治疗前(P<0.05)。观察组治疗后的血清UA水平显著高于对照组[(325.79±56.67)μmol/L vs(351.92±51.41)μmol/L,P<0.05]。两组患者治疗后的MoCA和MMSE评分显著高于治疗前,UPDRS评分显著低于治疗前(P<0.05)。观察组治疗后的MoCA和MMSE评分显著高于对照组,UPDRS评分显著低于对照组(P<0.05)。观察组的ADRs发生率与对照组无显著差异(17.5%vs 10.0%,P>0.05)。结论:与恩他卡朋单药治疗相比,帕金森病患者采用普拉克索联合恩他卡朋治疗,可抑制血清Hcy水平上调,促进血清UA水平增高,对神经功能的改善作用更显著。

Objective:To investigate the effects of pramipexole combined with entacapone on serum levels of homocysteine(Hcy)and uric acid(UA),as well as neurological function in the patients with Parkinson’s disease.Methods:Eighty patients with Parkinson’s disease admitted to Suzhou Municipal Hospital from February 2016 to February 2020 were included as research subjects and were randomly divided into 2 groups,each consisting of 40 patients.The control group was treated with entacapone on the basis of dopasin,while the observation group was treated with pramipexole on the basis of the regimen for the control group,both with a treatment course of 6 weeks.Serum levels of Hcy and UA in the two groups were detected before and 6 weeks after treatment.The clinical effects were compared between the two groups.The neurological function of the two groups was evaluated by the Montreal Cognitive Assessment(MoCA)scale and the Mini-mental State Examination(MMSE).The changes of limb motor function were analyzed by Unified Parkinson’s Disease Rating Scale(UPDRS),and the rate of adverse drug reactions was observed in the patients of the 2 groups.Results:The total effective rate in the observation group was 92.5%,which was significantly higher than 75.0%in the control group(P<0.05).After treatment,the serum levels of Hcy in the two groups were significantly lower than those before treatment,and the serum levels of UA was significantly higher than those before treatment(P<0.05).The serum level of UA in the observation group after treatment was significantly higher than that in the control group[(325.79±56.67)μmol/L vs(351.92±51.41)μmol/L,P<0.05].After treatment,the MoCA and MMSE scores in the patients of both groups significantly increased than those before treatment,while the UPDRS scores were significantly lower than those before treatment(P<0.05).The MoCA and MMSE scores of the observation group after treatment significantly elevated as compared with those of the control group,and the UPDRS scores were significantly lower than those of the control group(P<0.05).No significant differences could be seen in the rates of ADRs,when comparisons were made between the two groups(17.5%vs 10.0%,P>0.05).Conclusion:Compared with monotherapy with entacapone,pramipexole combined with entacapone could inhibit the up-regulation of Hcy in the treatment of Parkinson’s disease,and promote the increase of serum level of UA,with better effects on the improvement of neurological function.