Vartanian K Z
Zh Nevropatol Psikhiatr Im S S Korsakova. 1981;81(12):1777-81.
The content of adrenaline, noradrenaline, DOPA, and dopamine in the daily portion of the urine was examined in 26 patients with parkinsonism who took for many years L-DOPA which was then replaced by the drugs synemet and nacom containing, in addition to DOPA, a specific inhibitor of peripheral DOPA-decarboxylase (MK-486). As control 10 healthy subjects and 37 non-treated parkinsonic patients were examined. Advantages of the drugs synemet and nacom over L-DOPA are noted. These advantages manifest themselves in the form of favourable changes of the mediator balance in the presence of positive clinical effect and possibility of reducing the L-DOPA dose by administering those drugs. No substantial changes of biochemical parameters were revealed in the patients treated with synemet and nacom. A correlation between the hypersecretion of adrenaline and noradrenaline in the patients with parkinsonism treated with L-DOPA-containing drugs and the development of cerebral side effects (hyperkinesias, psychic disturbances) was discovered. Possible mechanisms of the development of the cerebral side effects in patients treated with DOPA-containing drugs are discussed, and necessity of combined therapy is stressed.
对26例帕金森病患者尿液每日样本中的肾上腺素、去甲肾上腺素、多巴和多巴胺含量进行了检测，这些患者多年来一直服用左旋多巴，后来改用信尼麦和纳康，除了多巴之外，这两种药物还含有外周多巴脱羧酶的特异性抑制剂（MK - 486）。作为对照，对10名健康受试者和37例未接受治疗的帕金森病患者进行了检测。文中指出了信尼麦和纳康相较于左旋多巴的优势。这些优势表现为在临床效果良好的情况下，递质平衡发生有利变化，并且通过使用这些药物有可能减少左旋多巴的剂量。使用信尼麦和纳康治疗的患者未发现生化参数有实质性变化。发现服用含左旋多巴药物治疗的帕金森病患者肾上腺素和去甲肾上腺素分泌过多与脑部副作用（运动过多、精神障碍）的发生之间存在相关性。文中讨论了服用含多巴药物治疗的患者出现脑部副作用的可能机制，并强调了联合治疗的必要性。
