Bonnet A M, Serre I, Marconi R, Agid Y, Dubois B
Fédération de Neurologie, Hôpital de la Salpêtrière, Paris, France.
Mov Disord. 1995 Sep;10(5):668-71. doi: 10.1002/mds.870100522.
The efficacy of pergolide as adjunct to levodopa therapy was compared to that of bromocriptine in 12 parkinsonian patients with fluctuating motor disability and levodopa-induced dyskinesias (mean age of onset, 50.6 +/- 8 years; Hoehn and Yahr stage between II and IV; mean basal UPDRS motor score, 30.6 +/- 8.6), in a double-blind crossover study. After an 8-day habituation to each agonist, an acute challenge of a supraliminal dose of levodopa ("levodopa test") was performed in association with either 1 mg pergolide or 10 mg bromocriptine. The delay to onset and the duration of therapeutic benefit, the percentage improvement in motor disability, and the severity of onset and peak-dose dyskinesias were evaluated. Both agonists significantly increased the duration of therapeutic benefit, but pergolide more so than bromocriptine (p = 0.02). Pergolide also tended to reduce the severity of dyskinesias and was globally perceived by the patients to be more efficacious than bromocriptine on parkinsonian symptoms and fluctuations. This study illustrated the usefulness of the "levodopa test" in evaluating, objectively, the effects of dopamine agonists.
在一项双盲交叉研究中，将培高利特作为左旋多巴治疗辅助药物的疗效与溴隐亭进行了比较，研究对象为12例帕金森病患者，这些患者存在运动功能波动障碍以及左旋多巴诱发的运动障碍（平均发病年龄50.6±8岁；Hoehn和Yahr分期为II至IV期；基础UPDRS运动评分平均为30.6±8.6）。在对每种激动剂进行8天的适应期后，分别联合1毫克培高利特或10毫克溴隐亭进行一次阈上剂量左旋多巴的急性激发试验（“左旋多巴试验”）。评估起效延迟时间、治疗益处持续时间、运动功能障碍改善百分比以及异动症发作和峰值剂量异动症的严重程度。两种激动剂均显著增加了治疗益处的持续时间，但培高利特的效果比溴隐亭更明显（p = 0.02）。培高利特还倾向于降低异动症的严重程度，并且患者总体感觉其在帕金森病症状和波动方面比溴隐亭更有效。这项研究说明了“左旋多巴试验”在客观评估多巴胺激动剂效果方面的有用性。
