多巴丝肼联合卡左双多巴控释片治疗帕金森病117例疗效观察

Therapeutic effect of dopamine hydrazine combined with carlobidopa controlled-release tablets in the treatment of 117 cases of Parkinson's disease

目的探讨多巴丝肼联合卡左双多巴控释片治疗帕金森病(PD)的临床疗效及其对患者炎症反应、血清同型半胱氨酸(Hcy)、人软骨糖蛋白40(YKL-40)水平的影响。方法采用病例对照研究,回顾性分析延安大学咸阳医院2020年1月至2022年12月治疗的PD患者230例的临床资料,按照治疗方法不同分为多巴丝肼组(多巴丝肼治疗,113例)和联合组(多巴丝肼联合卡左双多巴控释片治疗,117例),两组疗程6周。比较两组治疗前后炎症反应、血清Hcy、YKL-40的变化及临床疗效、不良反应发生情况。结果治疗6周,联合组肿瘤坏死因子α、白细胞介素1β、白细胞介素6、高敏C反应蛋白分别为(9.76±1.57)ng/L、(27.02±3.41)ng/L、(10.29±1.89)ng/L、(6.62±0.99)mg/L,均低于多巴丝肼组的(12.34±1.97)ng/L、(30.84±4.73)ng/L、(13.83±2.18)ng/L、(8.77±1.55)mg/L,差异均有统计学意义(t=-10.98、-7.04、-13.16、-12.58,均P<0.05);血清Hcy、YKL-40分别为(19.08±5.70)μmol/L、(3.33±0.97)g/L,均低于多巴丝肼组的(22.54±5.62)μmol/L、(4.03±1.23)g/L,差异均有统计学意义(t=-4.63、-4.81,均P<0.05)。联合组总有效率为94.02%(110/117),高于多巴丝肼组的78.76%(89/113)(χ^(2)=11.47,P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论多巴丝肼联合卡左双多巴控释片治疗PD,可降低炎症反应和血清Hcy、YKL-40水平,提高临床疗效,且不会增加不良反应。

Objective To investigate the clinical efficacy of dopamine hydrazine combined with carlobidopa controlled-release tablets in the treatment of Parkinson's disease and its effect on inflammatory reaction,serum homocysteine and YKL-40 levels in patients with Parkinson's disease.Methods A case-control study was conducted to retrospectively analyze the clinical data of 230 patients with Parkinson's disease who received treatment at Xianyang Hospital of Yan'an University from January 2020 to December 2022.According to the different treatment methods,these patients were divided into a dopamine hydrazine(treatment with dopamine hydrazine,n=113)and a combination group(treatment with dopamine hydrazine and carlobidopa controlled-release tablets,n=117).All patients were treated for 6 weeks.Inflammatory reactions,serum homocysteine levels,and serum YKL-40 levels post-treatment were compared with pre-treatment levels.Clinical efficacy and the incidence of adverse reactions were evaluated between the two groups.Results After 6 weeks of treatment,the levels of tumor necrosis factorα,interleukin-1β,interleukin-6,and high-sensitivity C-reactive protein in the combination group were(9.76±1.57)ng/L,(27.02±3.41)ng/L,(10.29±1.89)ng/L,and(6.62±0.99)mg/L,respectively,which were significantly lower than those in the dopamine hydrazine group[(12.34±1.97)ng/L,(30.84±4.73)ng/L,(13.83±2.18)ng/L,(8.77±1.55)mg/L,t=-10.98,-7.04,-13.16,-12.58,all P<0.05].The serum levels of homocysteine and YKL-40 in the combination group were(19.08±5.70)μmol/L and(3.33±0.97)g/L,respectively,which were significantly lower than those in the dopamine hydrazine group[(22.54±5.62)μmol/L,(4.03±1.23)g/L,t=-4.63,-4.81,both P<0.05].The total response rate in the combination group was 94.02%(110/117),which was significantly higher than 78.76%(89/113)in the dopamine hydrazine group(χ^(2)=11.47,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The use of dopamine hydrazine combined with carbidopa controlled-release tablets for the treatment of Parkinson's disease reduces inflammatory reactions,decreases serum homocysteine and YKL-40 levels,enhances clinical efficacy,and does not increase the incidence of adverse reactions.