摘要
目的探讨氯氮平治疗帕金森病(PD)左旋多巴诱导的异动症(levodopa-induced dyskinesias,LID)的临床疗效。方法将42例帕金森病患者随机分为氯氮平组与金刚烷胺组,每组21例,均应用美多巴和普拉克索作为帕金森病基础治疗。经12周联合用药治疗后,以统一帕金森病评定量表(UPDRS)各部分评分相对于基线(治疗前评分)的变化为指标评估疗效。同时监测血常规,观察患者不良反应,比较2组治疗方案的安全性。结果治疗12周后,氯氮平组和金刚烷胺组UPDRS-Ⅳa(治疗的并发症)评分相对基线均显著下降,差异有统计学意义(P<0.05),2组比较差异无统计学意义(P>0.05)。氯氮平组总有效率80.9%,金刚烷胺组为85.7%(P>0.05)。2组不良反应发生率分别为24%、29%,差异无统计学意义(P>0.05)。结论氯氮平治疗帕金森病左旋多巴导致的异动症可获得较显著的近期疗效。
Objective To investigate the efficacy ,safety and tolerability of clozapine in Parkinson＇s disease patients suffer-ing from dyskinesias .Methods Included in the present study were 40 PD patients with Parkinson＇s disease and dyskinesias who received clozapine or amantadine as an adjunct to levodopa and pramipexole for 12 weeks in our institute .The outcome meas-ures were changes in the unified Parkinson＇s disease rating scale part Ⅳa （UPDRS-Ⅳa） ,part Ⅳb （motor fluctuations ） ,and part Ⅲ （motor function） during each treatment period .The safety and tolerability were assessed on the basis of side effects and blood pressure .Results UPDRS-Ⅳa was improved to a significantly greater degree in patients of both groups treated for two weeks compared with those of before treatment （P〈0 .01） .However ,UPDRS-Ⅳa of two groups were no difference after two weeks＇treatment（P〉0 .05） .There were no significant effects on UPDRS-Ⅳb or Ⅲ scores between two groups after treatment （P〉0 .05） .No significant difference was found between the clozapine and amantadine groups in terms of adverse events （P〉0 .05） .Conclusion Results from the present study demonstrated that clozapine exhibited efficacious effects on dyskinesias in about 80% patients as amantadine did at least with short-term use .Its side effect of leukopenia is acceptable under strict mo-nito ring.
出处
《中国实用神经疾病杂志》
2014年第15期16-18,共3页
Chinese Journal of Practical Nervous Diseases
关键词
氯氮平
金刚烷胺
帕金森病
异动症
Clozapine
Amantadine
Parkinson＇s disease
Dyskinesias
