Nakamura Y, Yoshinaga J, Endo S, Hikiji A
Department of Neurology, Hiroshima City Hospital.
Rinsho Shinkeigaku. 1997 Jun;37(6):469-75.
We investigated clinical features of adverse reactions to long-term levodopa therapy by the multivariate analysis. Dyskinesia, wearing off effect, on-off effect, mental symptoms, and frozen gait were noted in 29 (11.2%), 78 (30.0%), 17 (6.5%), 45 (17.7%), and 52 (20.0%), respectively, of 260 patients with Parkinson's disease to whom levodopa had been administered for over one year. In the statistical investigation by the multivariate analysis (quantification method type II), the age of initial levodopa therapy, the duration from the onset to the initiation of levodopa therapy, and the duration of levodopa therapy were not closely related to the development of any adverse reaction, while Hoehn & Yahr's stage and the dosage of levodopa had the most significant influence on the development of adverse reactions. Furthermore, concomitant use of amantadine hydrochloride produced an inhibitory effect on the development of dyskinesia. We conclude that early institution of levodopa therapy in Parkinson's disease may not be an important risk factor of adverse reactions.
我们通过多因素分析研究了长期左旋多巴治疗不良反应的临床特征。在260例接受左旋多巴治疗超过一年的帕金森病患者中，异动症、疗效减退、开关现象、精神症状和冻结步态的发生率分别为29例（11.2%）、78例（30.0%）、17例（6.5%）、45例（17.7%）和52例（20.0%）。在多因素分析（II型量化法）的统计学研究中，左旋多巴初始治疗年龄、发病至开始左旋多巴治疗的时间以及左旋多巴治疗时间与任何不良反应的发生均无密切关系，而霍恩和雅尔分期以及左旋多巴剂量对不良反应的发生影响最为显著。此外，同时使用盐酸金刚烷胺对异动症的发生有抑制作用。我们得出结论，帕金森病早期开始左旋多巴治疗可能不是不良反应的重要危险因素。
