Isacson D, Bingefors K, Kristiansen I S, Nyholm D
Department of Pharmacy, Pharmacoepidemiology and Pharmacoeconomics, Uppsala University, Sweden.
Acta Neurol Scand. 2008 Dec;118(6):379-86. doi: 10.1111/j.1600-0404.2008.01049.x. Epub 2008 Jun 6.
To assess fluctuations in quality of life (QoL) and motor performance in patients with advanced Parkinson disease (PD) treated with continuous daytime duodenal levodopa/carbidopa infusion or conventional therapy.
Of 18 patients completing a 6-week trial (DIREQT), 12 were followed for up to 6 months and assessed using electronic diaries and the PD Questionnaire-39 (PDQ-39).
During the trial and follow-up, major diurnal fluctuations were observed, especially for hyperkinesia, 'off' time, ability to walk and depression. Duodenal infusion was associated with significantly more favourable outcomes compared with conventional treatment for satisfaction with overall functioning, 'off' time and ability to walk, with improved outcomes with PDQ-39.
Relative to conventional treatment, infusion therapy may stabilize and significantly improve motor function and patient's QoL. The potential for daily fluctuation in PD symptoms means single measures of treatment effectiveness can result in bias in effect estimates and hence repeated measures are recommended.
评估接受日间持续十二指肠左旋多巴/卡比多巴输注或传统疗法治疗的晚期帕金森病（PD）患者的生活质量（QoL）波动和运动表现。
在完成一项为期6周试验（DIREQT）的18例患者中，12例患者接受了长达6个月的随访，并使用电子日记和帕金森病问卷-39（PDQ-39）进行评估。
在试验和随访期间，观察到明显的昼夜波动，尤其是运动障碍、“关”期时间、行走能力和抑郁方面。与传统治疗相比，十二指肠输注在总体功能满意度、“关”期时间和行走能力方面的结局明显更有利，PDQ-39评分有所改善。
相对于传统治疗，输注疗法可能稳定并显著改善运动功能和患者的生活质量。帕金森病症状每日波动的可能性意味着单一的治疗效果测量可能导致疗效估计出现偏差，因此建议采用重复测量。
