全球精选文摘 - 在帕金森病中使用多巴胺激动剂对左旋多巴药物效应动力学的影响

高级搜索

免费注册

首页

期刊文献

全球精选文摘

中国作者重要发表

爱思唯尔期刊精选全文

柳叶刀中文版精选全文

2009年诺贝尔奖得主文章

成功投稿经验系列访谈

2010年度诺贝尔奖得主

医药资讯

医学资讯

药品动态

诊疗指南

病例分析

数据库

会议精粹

柳叶刀流感峰会

2009世界高血压大会

辉瑞中国医学研究高峰论坛

上海东方呼吸病国际论坛

GAP-CCBC系列会议

精品书籍

爱思唯尔参考书

新书订购活动

疾病资源

专家博客

当前位置 > > > >

在帕金森病中使用多巴胺激动剂对左旋多巴药物效应动力学的影响

Effects of a Dopamine Agonist on the Pharmacodynamics of Levodopa in Parkinson Disease

Brodsky MA, Park BS, Nutt JG 2010/4/21 16:31:23

【发表评论】【全球专家评论】

打印| 推荐给好友

Arch Neurol, 2010,

专家评级：

★★

循证评级：

View at Publisher

Background:
Treatment of Parkinson disease commonly includes levodopa and dopamine agonists; however, the interaction of these 2 drugs is poorly understood.

Objective:
To examine the effects of a dopamine agonist on the motor response to levodopa.

Design:
Double-blind, randomized, placebo-controlled, crossover clinical trial.

Setting:
Ambulatory academic referral center.

Patients:
Thirteen patients with idiopathic Parkinson disease taking levodopa and experiencing motor fluctuations and dyskinesia.

Interventions:
Eligible individuals were randomly assigned to receive pramipexole dihydrochloride or placebo for 4 weeks followed by a 2-hour intravenous levodopa infusion on consecutive days at 2 rates and with blinded assessments. They were then crossed over to the alternate oral therapy for 4 weeks followed by levodopa infusion and reassessment.

Main Outcome Measures:
Change in finger-tapping speed, measured using the area under the curve (AUC) for finger taps per minute across time; peak fingertapping speed; duration of response; time to “ON” (defined as a 10% increase in finger-tapping speed above baseline); walking speed; and dyskinesia AUC.

Results:
Pramipexole with levodopa infusion increased finger-tapping speed beyond the change in baseline by a mean (SE) of 170 (47.2) per minute×minutes (P=.006) and more than doubled the AUC for finger-tapping speed. Pramipexole increased peak finger-tapping speed by a mean (SE) of 18 (8.5) taps per minute (P=.02) and improved mean (SE) walking speed (15.9 [0.70] vs 18.9 [0.70] seconds, P=.004). Pramipexole prolonged duration of response after levodopa infusion and shortened time to ON. Pramipexole increased mean (SE) baseline dyskinesia scores (26.0 [5.85] vs 12.1 [5.85] points, P=.05) and peak dyskinesia scores with levodopa infusion.

Conclusions:
Pramipexole augmented the motor response to levodopa beyond a simple additive effect and increased the severity of levodopa-induced dyskinesia. When considering a combination of these therapies, an appropriate balance should be maintained regarding gain of motor function vs worsening of dyskinesia.

Trial Registration:
clinicaltrials.gov Identifier: NCT00666653

请登录后发表评论，点击此处登录。

全部学科

疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

更多>>>

医学数据库