比较溴隐亭和左旋多巴对帕金森病患者膀胱功能的影响。

Comparing bromocriptine effects with levodopa effects on bladder function in Parkinson's disease.

机构信息

Department of Neurology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.

出版信息

Mov Disord. 2009 Dec 15;24(16):2386-90. doi: 10.1002/mds.22840.

PMID:19908315

Abstract

To evaluate the effects of bromocriptine on bladder function in Parkinson's disease (PD) patients and compare these effects with those of (L-dopa). We recruited 8 patients with PD. Urodynamic study (UDS) was performed before and 1 hour after administering 100 mg L-dopa/decarboxylase inhibitor (DCI) and 2.5 hours after administering 7.5 mg bromocriptine. After the bromocriptine administration, urinary urgency aggravated. UDS revealed a decreased bladder volume at which detrusor overactivity (DO) was initiated, a decreased bladder volume at first sensation of bladder filling (FSV) (P < 0.05), an increased maximum Watts Factor value (WFmax) (detrusor contractility), a decreased Abrams-Griffiths (AG) number (urethral obstruction), and a decreased postvoid residual (PVR) (P < 0.01). Similarly, after the L-dopa administration, urinary urgency aggravated. UDS revealed an aggravated DO (P < 0.05), a decreased FSV and bladder capacity (P < 0.01, 0.05), an increased WFmax (P < 0.05), an increased AG number, and a decreased PVR (P < 0.01). A single dose of bromocriptine proved to exacerbate urinary urgency and DO in the storage phase, and improve bladder emptying through increased detrusor contractility and decreased bladder outlet obstruction, within hours. With the exception of bladder outlet obstruction, these effects of bromocriptine are similar to the effects of L-dopa, albeit slightly less pronounced.

摘要

目的

评估溴隐亭对帕金森病（PD）患者膀胱功能的影响，并与（L-多巴）的影响进行比较。我们招募了 8 名 PD 患者。在给予 100mg L-多巴/脱羧酶抑制剂（DCI）后 1 小时和给予 7.5mg 溴隐亭后 2.5 小时进行尿动力学研究（UDS）。给予溴隐亭后，尿急加重。UDS 显示启动逼尿肌过度活动（DO）的膀胱容量减少，首次感觉膀胱充盈（FSV）的膀胱容量减少（P<0.05），最大瓦特因子值（WFmax）增加（逼尿肌收缩力），Abrams-Griffiths（AG）数减少（尿道梗阻），以及残余尿量（PVR）减少（P<0.01）。同样，给予 L-多巴后，尿急加重。UDS 显示 DO 加重（P<0.05），FSV 和膀胱容量减少（P<0.01，0.05），WFmax 增加（P<0.05），AG 数增加，PVR 减少（P<0.01）。单次溴隐亭剂量在数小时内证明可加重储存期的尿急和 DO，并通过增加逼尿肌收缩力和减少膀胱出口梗阻来改善膀胱排空。除了膀胱出口梗阻外，溴隐亭的这些作用与 L-多巴的作用相似，尽管效果略逊一筹。