Vaamonde J, Ibáñez R, Gudín M, Hernández A
Servicio de Neurología, Complejo Hospitalario de Ciudad Real, Spain.
Neurologia. 2003 Apr;18(3):162-5.
Daily fluctuations of motor performance and dyskinesias in patients with Parkinson's disease (PD) treated with levodopa represent a difficult challenge to our understanding. We report 10 patients diagnosed of severe PD (Hoehn and Yahr: III-IV/V) treated with levodopa (range of dose: 750-900 mg/day) in single drug therapy since their diagnosis (mean time of levodopatherapy: 4.8 2.4 months, range: 3-6 months). All patients developed motor complications within weeks to months after initiating L-dopatherapy. Two patients received an intravenous apomorphine infusion (mean dose: 8.5 mg/day) during a mean time of 7.5 hours, but motor complications persisted during the infusion in spite of continuous dopaminergic stimulus. The degree of nigrostriatal damage (disease severity) seems to be a very important risk factor for the development of treatment-related motor complications.
帕金森病（PD）患者接受左旋多巴治疗时，运动表现和异动症的每日波动给我们的理解带来了难题。我们报告了10例诊断为重度PD（霍恩和雅尔分级：III-IV/V级）的患者，自诊断以来一直采用单药左旋多巴治疗（剂量范围：750-900毫克/天）（左旋多巴治疗的平均时间：4.8±2.4个月，范围：3-6个月）。所有患者在开始左旋多巴治疗后的数周内至数月内出现了运动并发症。两名患者在平均7.5小时的时间内接受了静脉注射阿扑吗啡输注（平均剂量：8.5毫克/天），但尽管持续给予多巴胺能刺激，输注期间运动并发症仍持续存在。黑质纹状体损伤程度（疾病严重程度）似乎是发生与治疗相关运动并发症的一个非常重要的危险因素。
