Dewey Richard B, Reimold Sharon C, O'Suilleabhain Padraig E
Department of Neurology and Division of Cardiology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9036, USA.
Arch Neurol. 2007 Mar;64(3):377-80. doi: 10.1001/archneur.64.3.377.
Although most studies have suggested an increased risk of valvulopathy (primarily regurgitation) with pergolide mesylate use, one study suggested that this problem may also occur with use of the non-ergot-derived dopamine agonists pramipexole dihydrochloride and ropinirole hydrochloride.
To determine if cardiac valve regurgitation occurs more commonly in patients with Parkinson disease (PD) treated with pergolide than in those treated with nonergot agonists at a comparable dose.
A case-control study of echocardiographic findings of valve function in patients receiving dopamine agonists for PD.
University-based referral center. Patients Thirty-six patients with idiopathic PD taking pergolide were compared with a matched control group of patients taking nonergot agonists with regard to the frequency and severity of cardiac valve regurgitation. Main Outcome Measure Valve scores (1 indicates trace; 2, mild; 3, moderate; and 4, severe) for the pergolide group were compared with those for the nonergot agonist control group.
The mean +/- SD valve regurgitation scores in the matched pergolide group compared with the nonergot group were as follows: aortic, 0.83 +/- 1.23 vs 0.19 +/- 0.53 (P = .01); mitral, 1.42 +/- 1.0 vs 0.39 +/- 0.65 (P<.001); and tricuspid, 1.43 +/- 1.0 vs 0.19 +/- 0.53 (P<.001). Lifetime exposure to a dopamine agonist was not statistically different between the pergolide and nonergot agonist groups (P = .18).
These data strengthen the conclusion that pergolide contributes to cardiac valve regurgitation when used in the long term as a treatment for PD. There appears to be low risk of cardiac valve regurgitation when using non-ergot-derived dopamine agonists.
尽管大多数研究表明使用甲磺酸培高利特会增加瓣膜病（主要是反流）的风险，但有一项研究表明，使用非麦角衍生的多巴胺激动剂盐酸普拉克索和盐酸罗匹尼罗也可能出现这个问题。
确定与使用同等剂量非麦角激动剂治疗的帕金森病（PD）患者相比，使用培高利特治疗的PD患者心脏瓣膜反流是否更常见。
一项针对接受多巴胺激动剂治疗PD患者的瓣膜功能超声心动图检查结果的病例对照研究。
大学附属医院转诊中心。
36例服用培高利特的特发性PD患者与一组服用非麦角激动剂的匹配对照组就心脏瓣膜反流的频率和严重程度进行比较。
比较培高利特组与非麦角激动剂对照组的瓣膜评分（1表示微量；2表示轻度；3表示中度；4表示重度）。
与非麦角组相比，匹配的培高利特组的平均±标准差瓣膜反流评分如下：主动脉瓣，0.83±1.23对0.19±0.53（P = 0.01）；二尖瓣，1.42±1.0对0.39±0.65（P<0.001）；三尖瓣，1.43±1.0对0.19±0.53（P<0.001）。培高利特组和非麦角激动剂组之间多巴胺激动剂的终生暴露量在统计学上无差异（P = 0.18）。
这些数据进一步证实了长期使用培高利特治疗PD会导致心脏瓣膜反流的结论。使用非麦角衍生的多巴胺激动剂时，心脏瓣膜反流的风险似乎较低。
