多巴胺受体激动剂普拉克索和单胺氧化酶B抑制剂司来吉兰治疗早期帕金森综合征的疗效对比  

Therapeutic effects comparison of Parkinson’s syndrome in the early stage treated by dopamine agonist pramipexole and monoamine oxidase B inhibitor selegiline

作　　者：杨丽娟[1] 牛晓珊[1] 何晓燕[1] 沙晶[1] 李红燕[1] Yang Lijuan;Niu Xiaoshan;He Xiaoyan;Sha Jing;Li Hongyan(Department of Neurology,the Xinjiang Uygur Autonomous Region People’s Hospital,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院神经内科

出　　处：《中华脑科疾病与康复杂志（电子版）》2018年第1期20-24,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：国家自然科学基金(31560270)

摘　　要：目的比较多巴胺受体激动剂普拉克索和单胺氧化酶B抑制剂司来吉兰治疗早期帕金森综合征的临床疗效。方法选择自2012年5月至2015年10月收治于新疆维吾尔自治区人民医院神经外科的帕金森病患者90例,按照随机数字表法分为对照组(30例)、普拉克索组(30例)和司来吉兰组(30例)。对照组仅给予美多巴(初始剂量为62.5 mg/次,根据治疗效果逐渐增加至125 mg/次,3次/d)治疗,普拉克索组和司来吉兰组在对照组的基础上分别给予普拉克索(1.0 mg/d)和司来吉兰(2.5 mg/d)进行治疗。所有患者治疗6个月,期间观察并记录患者临床症状改善情况以及治疗过程中出现的不良反应。采用统一PD评分量表(UPDRS)对患者进行评估,计算患者用药前后的UPDRS得分。结果普拉克索组与司来吉兰组治疗的总有效率分别为93.3%和90.0%,明显高于对照组(70.0%,P<0.05)。治疗前,普拉克索组、司来吉兰组和对照组的UPDRS评分差异无统计学意义(P>0.05)。在使用普拉克索和司来吉兰分别治疗后,患者的UPDRS评分显著下降,而对照组患者UPDRS评分下降不明显,普拉克索组、司来吉兰组与对照组的差异具有统计学意义(P<0.05)。普拉克索组的PD患者不良反应发生率(60.0%)明显多于司来吉兰组(6.7%,P<0.05),但症状均能自行缓解。结论普拉克索和司来吉兰均可有效改善早期帕金森症状,安全性好,但司来吉兰组的不良反应较少。Objective To compare the clinical efficacy of dopamine agonists pramipexole and monoamine oxidase inhibitors B selegiline in the treatment of early Parkinson’s disease (PD). Methods Ninety patients with earlier stage of PD from May 2012 to October 2015 in People’s Hospital of Xinjiang Uygur Autonomous Region were selected, They were divided into control group (30 cases), pramipexole group (30 cases) and selegiline group (30 cases) according to random number table. The control group were given dopamine (62.5 mg/time of the initial dose, the dose was gradually increased to 125 mg/time according to the treatment effect, 3 times a day), pramipexole group and selegiline group were given pramipexole (1 mg/d) and selegiline (2.5 mg/d) respectively in the basis of dopamine. The unified Parkinson’s disease rating scale (UPDRS) was adopted to evaluate patients, evaluation time respectively before and after treatment 1, 3, 6 months. At the same time, the adverse reactions were observed. Results The total effective rates in the pramipexole group and selegiline group were 93.3% and 90.0%, respectively, which were significantly higher than those in the control group (70.0%, P<0.05). Before treatment, the UPDRS score of pramipexole group, selegiline group and control groups was not statistically significant (P>0.05). The pramipexole group and selegiline group patients UPDRS score decreased significantly, while the control group of patients UPDRS score decline is not obvious, the difference was statistically significant (P<0.05). For adverse reactions, PD patients pramipexole group of adverse reactions (60%) was higher than selegiline group (6.7%)(P<0.05), but the symptoms can relieve itself. Conclusion The treatment of Pramipexole and selegiline in PD is effective, safe. And, adverse effects were less in the selegiline group.

关 键 词：帕金森病 普拉克索 司来吉兰 统一帕金森评分量表 

分 类 号：R742.5[医药卫生—神经病学与精神病学]