Stibe C M, Lees A J, Kempster P A, Stern G M
Department of Neurology, Faculty of Clinical Sciences, Middlesex.
Lancet. 1988 Feb 20;1(8582):403-6. doi: 10.1016/s0140-6736(88)91193-2.
Subcutaneous apomorphine, a dopamine agonist, was given by continuous infusion during the day or by repeated injections to 19 patients with Parkinson's disease disabled by severe on-off fluctuations. All patients were also given domperidone. The 11 patients treated by infusion showed marked and sustained improvement, and their mean duration of daily off periods over a period of 15 months fell by 6.3 h; similar results were obtained in 8 patients with less severe disabilities who were given repeated apomorphine injections. The therapeutic response to apomorphine was similar to that seen with intravenous levodopa; in patients treated by infusion the mean daily levodopa dose was reduced by 209 mg. These results confirm that during off periods dopamine receptors remain responsive to stimulation and provide evidence of a new, effective, and well-tolerated treatment for the most disabling complication of long-term levodopa therapy.
皮下注射阿扑吗啡（一种多巴胺激动剂），在白天持续输注或重复注射给19例因严重“开-关”波动而致残的帕金森病患者。所有患者同时还服用多潘立酮。11例接受输注治疗的患者显示出显著且持续的改善，其在15个月期间每日“关”期的平均时长缩短了6.3小时；8例残疾程度较轻且接受阿扑吗啡重复注射的患者也获得了类似结果。对阿扑吗啡的治疗反应与静脉注射左旋多巴所见相似；接受输注治疗的患者平均每日左旋多巴剂量减少了209毫克。这些结果证实，在“关”期多巴胺受体仍对刺激有反应，并为长期左旋多巴治疗最致残的并发症提供了一种新的、有效的且耐受性良好的治疗证据。
