Destée A, Bordet R
Clinique Neurologique, EA 2683 MENRT, Service de Pharmacologie clinique, EA 1046 MNERT, CHU Lille.
Rev Neurol (Paris). 2002 Dec;158 Spec no 1:S69-82.
Levodopa is the gold standard treatment for Parkinson's disease. The therapeutic effect may however be compromised by the inevitable risk of motor complications, with fluctuating motor control and dyskinesia, particularly in the younger patient. The Multiple pathophysiological mechanisms are undoubtedly involved but pulsed dopaminergic stimulation appears to play a determining role. This underlines the importance of a treatment which achieves a most stable and physiological dopaminergic stimulation as possible. Dopaminergic agonists provide a promising alternative. Another possibility is to modulate the peripheral kinetics of levodopa as soon as it is introduced using catechol-O-methyl transferase inhibitors.
左旋多巴是帕金森病的金标准治疗药物。然而，运动并发症的不可避免风险可能会损害其治疗效果，出现运动控制波动和异动症，尤其是在年轻患者中。多种病理生理机制无疑都参与其中，但脉冲式多巴胺能刺激似乎起决定性作用。这凸显了一种能实现尽可能稳定和生理性多巴胺能刺激的治疗方法的重要性。多巴胺能激动剂提供了一种有前景的替代方案。另一种可能性是在引入左旋多巴后立即使用儿茶酚-O-甲基转移酶抑制剂来调节其外周动力学。
