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帕金森病与左旋多巴诱发的运动并发症的发生:基线特征和首次治疗方法的影响

Parkinson's Disease and development of levodopa induced motor complications: Influence of baseline features and first medical approach.

作者信息

Rua Rafael Alexandra Sofia, Pinto Barbosa Joselina Maria, Silva Leão Rosas Maria José, Lobo Almeida Garrett Maria Carolina

机构信息

Faculty of Medicine of Porto University, Porto, Portugal.

Medical Educational Center, Faculty of Medicine of Porto University, Porto, Portugal.

出版信息

Porto Biomed J. 2016 Sep-Oct;1(4):136-141. doi: 10.1016/j.pbj.2016.08.001. Epub 2016 Sep 17.

Abstract

BACKGROUND

The introduction of levodopa in clinical practice represents a hallmark in the treatment of the neurodegenerative disease, Parkinson's Disease. However, levodopa induced motor complications, namely dyskinesias and motor fluctuations, develop in the majority of Parkinson's Disease patients.

OBJECTIVE

to identify which Parkinson's Disease's, patient's and therapeutics' initial features are more associated with dyskinesias or motor fluctuations development.

METHODS

Patients with diagnosed Parkinson's Disease attending neurology outpatient clinic at Centro Hospitalar São João were selected. For this observational study, data was retrospectively collected from patient's clinical records. A survival analysis model with univariate and multivariate regression analysis was used.

RESULTS

87 patients with a mean of 72 ± 9.7 years were included. After a median follow-up of 6 (range 1-17) years, 35.6% patients developed dyskinesias; and with a median of 5 (range 1-16) years, 32.2% developed motor fluctuations. After multivariate analysis, the akinesia/rigidity subtype was found to have a higher risk of dyskinesias and motor fluctuations development. Age of onset ≤50 years was associated with motor fluctuations development.

CONCLUSION

In conclusion, our results suggest that Parkinson's Disease patients' initial characteristics, such as subtype or age of onset, are independently associated with the development of motor complications.

摘要

背景

左旋多巴引入临床实践是神经退行性疾病帕金森病治疗的一个里程碑。然而,大多数帕金森病患者会出现左旋多巴诱发的运动并发症,即异动症和运动波动。

目的

确定帕金森病患者的哪些初始特征、患者特征和治疗特征与异动症或运动波动的发生更相关。

方法

选取在圣若昂中心医院神经科门诊就诊的帕金森病确诊患者。对于这项观察性研究,从患者的临床记录中回顾性收集数据。使用单变量和多变量回归分析的生存分析模型。

结果

纳入87例平均年龄为72±9.7岁的患者。中位随访6年(范围1 - 17年)后,35.6%的患者出现异动症;中位随访5年(范围1 - 16年)后,32.2%的患者出现运动波动。多变量分析后发现,运动不能/强直亚型发生异动症和运动波动的风险更高。发病年龄≤50岁与运动波动发生相关。

结论

总之,我们的结果表明,帕金森病患者最初的特征,如亚型或发病年龄,与运动并发症独立相关。

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本文引用的文献

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Mortality in levodopa-treated Parkinson's disease.左旋多巴治疗的帕金森病患者的死亡率。
Parkinsons Dis. 2014;2014:426976. doi: 10.1155/2014/426976. Epub 2014 Jan 28.
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Treatment of Parkinson's disease in the advanced stage.帕金森病晚期的治疗。
J Neural Transm (Vienna). 2013 Apr;120(4):523-9. doi: 10.1007/s00702-013-1008-y. Epub 2013 Mar 10.
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Parkinson disease: from pathology to molecular disease mechanisms.帕金森病:从病理学到分子疾病机制。
Free Radic Biol Med. 2013 Sep;62:132-144. doi: 10.1016/j.freeradbiomed.2013.01.018. Epub 2013 Feb 4.

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