Yang Hui-Jun, Ehm Gwanhee, Kim Young Eun, Yun Ji Young, Lee Woong-Woo, Kim Aryun, Kim Han-Joon, Jeon Beomseok
Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Neurology, Myongji Hospital, Seonam University College of Medicine, Goyang, Republic of Korea.
J Neurol Sci. 2017 Jun 15;377:6-11. doi: 10.1016/j.jns.2017.03.039. Epub 2017 Mar 23.
While levodopa, carbidopa, ascorbic acid solution (LCAS) therapy has been used in patients with advanced Parkinson's disease (PD) for many years, long-term follow-up data is scarce. The present study aimed to determine the long-term retention rate for LCAS therapy, and to identify the causes of LCAS therapy withdrawal. Our study included a series of 38 patients with PD (14 men and 24 women) who underwent LCAS treatment between 2011 and 2013 to alleviate motor complications that were not satisfactorily controlled by optimized conventional anti-parkinsonian treatment at the Seoul National University Hospital. All patients were admitted to educate them about and initiate LCAS treatment for 2-5days, and were then followed up as outpatients. The mean follow-up duration was 12.8months, and three main reasons for LCAS treatment discontinuation were worsening of wearing-off symptoms (8 patients), persistent dyskinesia (4 patients), and poor drug adherence (4 patients). Fourteen patients (36.8%) maintained the LCAS treatment after 12months, and were categorized as the treatment-retention group. The mean percentage of on time without dyskinesia significantly increased from 33.6±17.6% to 57.0±27.7% after LCAS initiation (p=0.016) in the treatment-retention group. Twelve patients (31.6%) were still receiving LCAS treatment after 30months. LCAS treatment can be a non-device assisted therapeutic option for patients who have no access to advanced therapies such as deep brain stimulation and infusional treatments.
虽然左旋多巴、卡比多巴、抗坏血酸溶液（LCAS）疗法已用于晚期帕金森病（PD）患者多年，但长期随访数据稀缺。本研究旨在确定LCAS疗法的长期保留率，并找出停用LCAS疗法的原因。我们的研究纳入了2011年至2013年间在首尔国立大学医院接受LCAS治疗以缓解运动并发症的38例PD患者（14例男性和24例女性），这些运动并发症在优化的传统抗帕金森病治疗下未得到满意控制。所有患者入院接受2 - 5天的LCAS治疗相关教育并开始治疗，然后作为门诊患者进行随访。平均随访时间为12.8个月，停用LCAS治疗的三个主要原因是剂末现象加重（8例患者）、持续性异动症（4例患者）和药物依从性差（4例患者）。14例患者（36.8%）在12个月后维持LCAS治疗，被归类为治疗保留组。在治疗保留组中，开始LCAS治疗后无异动症的平均准时百分比从33.6±17.6%显著增加到57.0±27.7%（p = 0.016）。12例患者（31.6%）在30个月后仍在接受LCAS治疗。对于无法获得诸如脑深部刺激和输注治疗等先进疗法的患者，LCAS治疗可以是一种非设备辅助的治疗选择。
