单次标准左旋多巴剂量对帕金森病患者心脏自主神经功能的影响。

Effect of a single dose of standard levodopa on cardiac autonomic function in Parkinson's disease.

机构信息

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.

出版信息

Neurol India. 2011 Sep-Oct;59(5):659-63. doi: 10.4103/0028-3886.86536.

DOI:10.4103/0028-3886.86536

PMID:22019646

Abstract

BACKGROUND

Parkinson's disease (PD) is associated with autonomic dysfunction and chronic levodopa therapy has been reported to impair the autonomic control of heart rate.

AIM

Our aim was to assess the immediate effect of a single dose of levodopa on heart rate variability (HRV) in idiopathic PD.

MATERIALS AND METHODS

Eleven patients of idiopathic PD (F:M =2:9, mean age 57.3±8.6 years, duration of illness 4.1±2.8 years, Hoehn and Yahr stage 2.1±0.2) on stable levodopa dosage were studied. Motor part of unified Parkinson's disease rating scale and resting Lead II electrocardiogram (ECG) recordings were performed at baseline (12 hours off medication) and after two tablets of 100/10 mg of standard levodopa/ carbidopa. ECG was recorded continuously in the first hour (H1) followed by a 15-min recording in second (H2), third (H3) and fourth (H4) hours. Artifact free 5-min segments of the ECG were analyzed offline to obtain the HRV parameters in time domain (ms) and frequency domains (ms 2 ).

RESULTS

Significant increase was observed in standard deviation of normal to normal intervals (23.5±2.7-46.2±6.6, P<0.05), root mean square of successive differences of NN intervals (16.3±2.9-30.7±5.1, P<0.01), total power (568.9±125.7-2739±667.5, P<0.01), low frequency power (146.5±40.8-614.1±206.7, P<0.05) and high frequency power (107.4±33.9-332.7±85.9, P<0.05) in H1.

CONCLUSION

The results are suggestive of an improvement in the overall variability of the heart rate indicating an enhanced vagal tone.

摘要

背景

帕金森病（PD）与自主神经功能障碍有关，并且已有报道称慢性左旋多巴治疗会损害心率的自主控制。

目的

我们的目的是评估单次左旋多巴剂量对特发性 PD 患者心率变异性（HRV）的即时影响。

材料和方法

研究了 11 名特发性 PD 患者（F：M=2：9，平均年龄 57.3±8.6 岁，病程 4.1±2.8 年，Hoehn 和 Yahr 分期 2.1±0.2），他们处于稳定的左旋多巴剂量。在基线（停药 12 小时）和服用两片 100/10mg 标准左旋多巴/卡比多巴后，进行统一帕金森病评定量表的运动部分和静息 II 导联心电图（ECG）记录。在第一小时（H1）连续记录心电图，然后在第二（H2）、第三（H3）和第四（H4）小时记录 15 分钟的记录。离线分析无伪迹的 5 分钟 ECG 片段，以获得时域（ms）和频域（ms 2 ）中的 HRV 参数。

结果

在 H1 中观察到正常到正常间隔的标准差显著增加（23.5±2.7-46.2±6.6，P<0.05），NN 间隔连续差值的均方根（16.3±2.9-30.7±5.1，P<0.01），总功率（568.9±125.7-2739±667.5，P<0.01），低频功率（146.5±40.8-614.1±206.7，P<0.05）和高频功率（107.4±33.9-332.7±85.9，P<0.05）。