Mishra Om, Mallik Ashok K, Dash Santosh Kumar, Das Pragateshnu, Dash Manoranjan
Neurology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Neurology, SCB (Srirama Chandra Bhanja) Medical College and Hospital, Cuttack, IND.
Cureus. 2024 Apr 20;16(4):e58662. doi: 10.7759/cureus.58662. eCollection 2024 Apr.
This investigation aimed to thoroughly characterize the range of pulmonary function abnormalities present in individuals with Parkinson's disease (PD) and to evaluate the effects of levodopa therapy on these respiratory dysfunctions.
Ninety-five PD patients diagnosed via the UK Parkinson's Disease Society Brain Bank Diagnostic Criteria were recruited, excluding those with a smoking history or unable to perform pulmonary function tests (PFTs). Severity was assessed using the Hoehn and Yahr Scale. Spirometry-measured PFT parameters (forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow rate (PEFR)) were compared against matched predicted values. The changes in PFT parameters post-levodopa challenge were assessed.
Most of the PD patients were aged between 51-60 years, with a mean age of 55.89 ± 8.37 years. Of these, 65.3% were male. A significant proportion of the cohort exhibited restrictive pulmonary patterns (73.7%), while a smaller fraction displayed obstructive (7.4%) or normal (18.9%) pulmonary function patterns. Notably, levodopa treatment correlated with marked improvements in all measured PFT parameters, especially evident in the enhancements from the "off" medication stage to the "on" stage for FVC and FEV1 (P=0.0001). A weak positive correlation between the severity of respiratory restriction and the duration of PD (r = 0.139, P = 0.021) was found, suggesting that PD's progression exerts an increasingly adverse effect on respiratory function over time.
The findings of this study illustrate that restrictive pulmonary abnormalities are more prevalent than obstructive patterns in PD patients and that these patients respond favorably to levodopa therapy.
本研究旨在全面描述帕金森病(PD)患者存在的肺功能异常范围,并评估左旋多巴治疗对这些呼吸功能障碍的影响。
招募了95名根据英国帕金森病协会脑库诊断标准确诊的PD患者,排除有吸烟史或无法进行肺功能测试(PFT)的患者。使用Hoehn和Yahr量表评估疾病严重程度。将通过肺活量测定法测量的PFT参数(用力肺活量(FVC)、第1秒用力呼气量(FEV1)和呼气峰值流速(PEFR))与匹配的预测值进行比较。评估左旋多巴激发试验后PFT参数的变化。
大多数PD患者年龄在51 - 60岁之间,平均年龄为55.89±8.37岁。其中,65.3%为男性。该队列中很大一部分表现出限制性肺模式(73.7%),而较小比例表现为阻塞性(7.4%)或正常(18.9%)肺功能模式。值得注意的是,左旋多巴治疗与所有测量的PFT参数显著改善相关,在从“关”药阶段到“开”药阶段FVC和FEV1的改善中尤为明显(P = 0.0001)。发现呼吸受限严重程度与PD病程之间存在弱正相关(r = 0.139,P = 0.021),表明随着时间的推移,PD的进展对呼吸功能产生越来越不利的影响。
本研究结果表明,PD患者中限制性肺异常比阻塞性模式更普遍,并且这些患者对左旋多巴治疗反应良好。