Sharma J C, Ross I N, Rascol O, Brooks D
Newark Hospital, Newark, UK.
Eur J Neurol. 2008 May;15(5):493-6. doi: 10.1111/j.1468-1331.2008.02106.x. Epub 2008 Mar 18.
Levodopa dose per kilogram body weight is reported to be a significant factor for dyskinesia in Parkinson's disease. We have investigated this hypothesis in data from the studies comparing ropinirole versus levodopa as the initial therapy.
Data from the ropinirole versus levodopa studies 056 and REAL-PET in early Parkinson's disease were pooled and manipulated to calculate levodopa dose per kilogram body weight. Logistic regression analysis was performed to investigate significant variables for the development of dyskinesia. Only the patients on levodopa monotherapy or with ropinirole were analyzed.
Analysis of levodopa therapy patients revealed that dyskinetic patients had received significantly higher absolute levodopa dose and levodopa dose per kilogram body weight. Logistic regression revealed that the most significant factor was the higher levodopa dose per kilogram body weight, P = 0.005, odds ratio 1.078, 95% CI 1.023-1.135; younger age was the second factor -P = 0.026. Variables of gender, absolute levodopa dose, weight, disease duration and initial motor Unified Parkinson's disease rating score were not significant.
Higher levodopa dose per kilogram body weight is an independently significant factor for developing dyskinesia. This relationship should be considered in treatment of Parkinson's disease patients aiming to prevent and manage dyskinesia.
据报道，每千克体重的左旋多巴剂量是帕金森病异动症的一个重要因素。我们在比较罗匹尼罗与左旋多巴作为初始治疗的研究数据中对这一假设进行了调查。
汇总并处理帕金森病早期罗匹尼罗与左旋多巴研究056和REAL-PET的数据，以计算每千克体重的左旋多巴剂量。进行逻辑回归分析以研究异动症发生的显著变量。仅分析接受左旋多巴单药治疗或联合罗匹尼罗的患者。
对左旋多巴治疗患者的分析显示，异动症患者接受的绝对左旋多巴剂量和每千克体重的左旋多巴剂量显著更高。逻辑回归显示，最显著的因素是每千克体重更高的左旋多巴剂量，P = 0.005，比值比1.078，95%置信区间1.023 - 1.135；年龄较小是第二个因素——P = 0.026。性别、绝对左旋多巴剂量、体重、病程和初始运动统一帕金森病评定量表评分等变量不显著。
每千克体重更高的左旋多巴剂量是发生异动症的一个独立显著因素。在旨在预防和管理异动症的帕金森病患者治疗中应考虑这种关系。
