晚期帕金森病患者自主神经系统对左旋多巴的反应。

Autonomic nervous system response to L-dopa in patients with advanced Parkinson's disease.

作者信息

Ruonala Verneri, Tarvainen Mika P, Karjalainen Pasi A, Pekkonen Eero, Rissanen Saara M

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:6162-5. doi: 10.1109/EMBC.2015.7319799.

DOI:10.1109/EMBC.2015.7319799

Abstract

Levodopa is the main treatment method for reducing the symptoms of Parkinson's disease. Whereas it reduces the motor symptoms efficiently, its effect on autonomous nervous system is not clear. The information about effect of levodopa on heart rate variability is not coherent between the studies. In this study, ECG of 11 patients with Parkinson's disease was measured during levodopa challenge with pronounced dose of fast release levodopa to ensure the positive drug effect for deep brain stimulation treatment. Heart rate variability analysis was done at three time points, before administration of levodopa, 30 and 60 minutes after administration. After 30 minutes of administration, the HRV parameters show that parasympathetic nervous system activity is decreased and the sympatho-vagal balance is shifted towards sympathetic control. At 60 minutes after administration the parasympathetic nervous system activates slightly and causes a decrease in heart rate.

摘要

左旋多巴是减轻帕金森病症状的主要治疗方法。虽然它能有效减轻运动症状，但其对自主神经系统的影响尚不清楚。关于左旋多巴对心率变异性影响的研究结果并不一致。在本研究中，对11例帕金森病患者在使用大剂量速释左旋多巴进行左旋多巴激发试验期间进行心电图测量，以确保对深部脑刺激治疗有积极的药物效果。在三个时间点进行心率变异性分析，即左旋多巴给药前、给药后30分钟和60分钟。给药30分钟后，心率变异性参数显示副交感神经系统活动降低，交感-迷走神经平衡向交感神经控制方向偏移。给药60分钟后，副交感神经系统略有激活并导致心率下降。