吡呗地尔和左旋多巴对早期帕金森病患者多巴胺转运体及运动功能的影响  

Impacts of piribedil and levodopa on ^(99m)Tc-TRODAT-1-SPECT imaging and motor function of early stage Parkinson′s disease

作　　者：钱进军[1] 程言博[1] 刘春风[1] 毛成洁[1] 李学忠[1] 

机构地区：[1]苏州大学附属第二医院神经病科,215004

出　　处：《江苏医药》2007年第5期447-449,共3页Jiangsu Medical Journal

基　　金：卫生部科学研究基金项目(WKJ20052030)

摘　　要：目的观察吡呗地尔和左旋多巴对早期帕金森病(PD)患者多巴胺转运体(DAT)活性和运动功能的影响。方法选择早期PD患者43例,以治疗方案不同分为左旋多巴与吡呗地尔合用组(15例),单用吡呗地尔组(12例),单用左旋多巴组(16例)。采用PD统一评分量表(UPDRSⅢ)对患者进行治疗前的运动功能基线评定,并在治疗后1、3和6个月进行跟踪随访。采用99mTc-TRO-DAT-1-单光子发射计算机断层扫描(SPECT)对患者进行治疗前的基线DAT活性评定,并在治疗后6个月末复查SPECT。结果(1)与入组治疗前的基线比较,合用组、单用左旋多巴组3和6个月后UPDRSⅢ降低(P<0·05或P<0·01)。(2)反映DAT活性的ST/CB放射性摄取率从基线到6个月末的总体变化程度为:合用组下降了2·71%(P<0·05),单用吡呗地尔组下降了3·61%(P<0·05),单用左旋多巴组下降了10·44%(P<0·01)。结论单用吡呗地尔对早期PD患者的运动功能改善不明显,但延缓了纹状体DAT活性的下降。而单用左旋多巴可显著改善早期PD患者运动功能,但纹状体的DAT活性却明显下降。吡呗地尔联用左旋多巴不仅明显改善了患者运动功能,而且显著延缓了纹状体DAT活性的下降。Objective To observe the impacts of piribedil and levodopa on the dopamine transporters and motor functions in early Parkinson＇s disease（PD） patients. Methods Fourty-three early stage PD patients were divided into co-therapy with piribedil and levodopa group （C, n=15）, piribedil monotherapy group（P, n= 12）, and levodopa monotherapy group（L, n= 16）. Patients＂ motor functions were estimated in light of the unified PD rating scale motor scores （UPDRS Ⅲ）, and then were followed up at the end of the 1st, 3rd and 6th month after treatment, respectively. DAT activities were estimated with ^99mTe-TRODAT-1-SPECT imaging, and followed up at the end of the 6 th month after treatment. Results （1） Compared with the baseline, the UPDRS III scores in group C were significantly decreased at the end of the 3rd and 6th month after treatment（P〈0.01） . So did in group L （P〈0. 05, and P〈0.01）. （2） The radioactive uptake rate of ST/CB , reflecting dopamine transporter＇s activity, was decreased by 10.44% in group L（P〈0.01）, 3.61% in group P（P〈0. 05） and 2.71% in group C（P〈0.05） ,respectively. Conclusion Piribedil monotherapy has a little influence on motor improvement, but reduces the loss of striatal dopamine transporter＇s activity in early stage PD patients. Levodopa monotherapy has a marked effect on motor improvement, but speeds up the loss of striatal dopamine transporter＇s activity in early stage PD patients. Co-therapy of levodopa and piribedil has not only greatly effect on motor improvement, but also significantly reduces the loss of striatal dopamine transporter＇s activity in early stage PD patients.

关 键 词：帕金森病 单光子发射计算机断层扫描 多巴胺转运体 多巴胺受体激动剂 

分 类 号：R742[医药卫生—神经病学与精神病学]