The Movement Disorders Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
J Neurol. 2010 Nov;257(Suppl 2):S309-13. doi: 10.1007/s00415-010-5718-x.
The mainstay of Parkinson's disease (PD) therapy is levodopa. The crucial question is when should levodopa be initiated? Levodopa provides the most potent motor benefit for PD, but longer term use is marked by the development of motor complications such as fluctuations in response and involuntary motor movements. Dopamine agonists reduce the risk of development of motor complications in the 5-year term. However, side effects may change the risk-benefit of dopamine agonist first strategies. In the following, the evidence for levodopa and dopamine agonists as initial monotherapy for PD is examined.
帕金森病（PD）治疗的主要手段是左旋多巴。关键问题是何时开始使用左旋多巴？左旋多巴为 PD 提供最有效的运动益处，但长期使用会出现运动并发症，如反应波动和不自主运动。多巴胺激动剂可降低 5 年内运动并发症的发生风险。然而，副作用可能会改变多巴胺激动剂初始策略的风险效益。在下面，将检查左旋多巴和多巴胺激动剂作为 PD 初始单药治疗的证据。
