魏明,杨秀,佟强,欧洲

• 1:南京医科大学附属淮安第一医院

摘要(Abstract)：

目的探讨恩他卡朋双多巴联合B族维生素对中晚期帕金森患者的临床疗效。方法收集中晚期帕金森病(PD)患者80例,将其随机分为美多芭组、美多芭+B族维生素组、达灵复组、达灵复+B族维生素组,治疗6个月后评估LD血药浓度、UPDRSⅢ评分、H-Y分级、PSQI、PDQ-39等指标。结果与治疗前相比,达灵复+B族维生素组能显著降低血浆Hcy水平以及PSQI、PDQ-39、UPDRSⅢ评分(P<0.05),提高LD血药浓度(P<0.05);与美多芭+B族维生素组相比,达灵复+B族维生素组可提高LD血药浓度(P<0.05),降低血浆Hcy水平(P<0.05)。结论达灵复联合B族维生素可提高中晚期PD患者LD血药浓度,降低血浆Hcy水平,改善临床症状和生活质量。

关键词(KeyWords)： 帕金森病;达灵复;B族维生素;同型半胱氨酸;血药浓度

Abstract:

Keywords:

基金项目(Foundation): 江苏省自然科学基金(编号:BK20191212)

作者(Author): 魏明,杨秀,佟强,欧洲

参考文献(References)：

• [1] EXNER N,LUTZ A K,HAASS C,et al.Mitochondrial dysfunction in Parkinson's disease:molecular mechanisms and pathophysiological consequences[J].EMBO J,2012,31(14):3038-3062.DOI:10.1038/emboj.2012.170.
• [2] HENCHCLIFFE C,BEAL M F.Mitochondrial biology and oxidative stress in Parkinson disease pathogenesis[J].Nat Clin Pract Neurol,2008,4(11):600-609.DOI:10.1038/ncpneuro0924.
• [3] ABOU-SLEIMAN P M,MUQIT M M,WOOD N W.Expanding insights of mitochondrial dysfunction in Parkinson's disease[J].Nat Rev Neurosci,2006,7(3):207-219.DOI:10.1038/nrn 1868.
• [4] HOMAYOUN H.Parkinson Disease[J].Ann Intern Med,2018,169(5):C33-C48.DOI:10.7326/AITC201809040.
• [5] ZHAO H R,JIANG T,TIAN Y Y,et al.Angiotensin II triggers apoptosis via enhancement of NADPH oxidase-dependent oxidative stress in a dopaminergic neuronal cell line[J].Neurochem Res,2015,40(4):854-863.DOI:10.1007/s11064-015-1536-y.
• [6] GAO Q,JIANG T,ZHAO H R,et al.Activation of Autophagy Contributes to the Angiotensin II-Triggered Apoptosis in a Dopaminergic Neuronal Cell Line[J].Mol Neurobiol,2016,53(5):2911-2919.DOI:10.1007/s12035-015-9177-3.
• [7] OU Z,JIANG T,GAO Q,et al.Mitochondrial-dependent mechanisms are involved in angiotensin II-induced apoptosis in dopaminergic neurons[J].J Renin Angiotensin Aldosterone Syst,2016,17(4).DOI:10.1177/1470320316672349.
• [8] MCKINNON C,De SNOO M L,GONDARD E,et al.Early-onset impairment of the ubiquitin-proteasome system in dopaminergic neurons caused by alpha-synuclein[J].Acta Neuropathol Commun,2020,8(1):17.DOI:10.1186/s40478-020-0894-0.
• [9] HOU L,QU X,QIU X,et al.Integrin CD11b mediates locus coeruleus noradrenergic neurodegeneration in a mouse Parkinson's disease model[J].J Neuroinflammation,2020,17(1):148.DOI:10.1186/s12974-020-01823-3.
• [10] WANG W,WANG X,FUJIOKA H,et al.Parkinson's disease-associated mutant VPS35 causes mitochondrial dysfunction by recycling DLP1 complexes[J].Nat Med,2016,22(1):54-63.DOI:10.1038/nm.3983.
• [11] 焦淑洁,刘亚玲,朱红灿,等.脑脊液α-突触核蛋白和SWI在早期帕金森病诊断中的价值[J].中国实用神经疾病杂志,2019,22(3):246-252.DOI:10.12083/SYSJ.2019.03.048
• [12] BOHNEN N I,FREY K A,STUDENSKI S,et al.Gait speed in Parkinson disease correlates with cholinergic degeneration[J].Neurology,2013,81(18):1611-1616.DOI:10.1038/nm.3983.
• [13] LOENS S,CHORBADZHIEVA E,KLEIMANN A,Dressler D,et al.Effects of levodopa/carbidopa intestinal gel versus oral levodopa/carbidopa on B vitamin levels and neuropathy[J].Brain Behav,2017,7(5):e00698.DOI:10.1002/brb3.698.
• [14] SKODDA S,MüLLER T.Refractory epileptic seizures due to vitamin B6 deficiency in a patient with Parkinson's disease under duodopa? therapy[J].J Neural Transm (Vienna),2013,120(2):315-8.DOI:10.1007/s00702-012-0856-1.
• [15] CHRISTINE C W,AUINGER P,JOSLIN A,et al.Vitamin B12 and Homocysteine Levels Predict Different Outcomes in Early Parkinson's Disease[J].Mov Disord,2018,33(5):762-770.DOI:10.1002/mds.27301.
• [16] SECHI G,SECHI E,FOIS C,et al.Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults[J].Nutr Rev,2016,74(5):281-300.DOI:10.1093/nutrit/nuv107.
• [17] KUOPPAMAKI M,LEINONEN M,POEWE W.Efficacy and safety of entacapone in levodopa/carbidopa versus levodopa/benserazide treated Parkinson's disease patients with wearing-off[J].J Neural Transm (Vienna),2015,122(12):1709-1714.DOI:10.1007/s00702-015-1449-6.
• [18] KOCER B,GUVEN H,COMOGLU S S.Homocysteine Levels in Parkinson's Disease:Is Entacapone Effective?[J].Biomed Res Int,2016,2016:7563705.DOI:10.1155/2016/7563705.
• [19] YAN M H,WANG X,ZHU X.Mitochondrial defects and oxidative stress in Alzheimer disease and Parkinson disease[J].Free Radic Biol Med,2013,62:90-101.DOI:10.1016/j.free radbiomed.2012.11.014.
• [20] REICH S G,SAVITT J M.Parkinson's Disease[J].Med Clin North Am,2019,103(2):337-350.DOI:10.1016/j.mcna.2018.10.014.
• [21] HAYES M W,FUNG V S,KIMBER T E,et al.Updates and advances in the treatment of Parkinson disease[J].Med J Aust,2019,211(6):277-283.DOI:10.5694/mja2.50224.
• [22] DIETRICHS E,ODIN P.Algorithms for the treatment of motor problems in Parkinson's disease.Acta Neurol Scand,2017,136(5):378-385.DOI:10.1111/ane.12733.
• [23] OLANOW C W,KIEBURTZ K,STERN M,et al.Double-blind,placebo-controlled study of entacapone in levodopa-treated patients with stable Parkinson disease[J].Arch Neurol,2004,61(10):1563-1568.DOI:10.1001/archneur.61.10.1563.
• [24] ARMSTRONG M J,OKUN M S.Diagnosis and Treatment of Parkinson Disease:A Review[J].JAMA,2020,323(6):548-560.DOI:10.1001/jama.2019.22360.
• [25] STODDARD-BENNETT T,REIJO PERA R.Treatment of Parkinson's Disease through Personalized Medicine and Induced Pluripotent Stem Cells.Cells,2019,8(1):26.DOI:10.3390/cells8010026.
• [26] ZESIEWICZ T A.Parkinson Disease[J].Continuum (Minneap Minn),2019,25(4):896-918.DOI:10.1212/CON.0000000000000764.
• [27] SAVITT D,JANKOVIC J.Targeting α-Synuclein in Parkinson's Disease:Progress Towards the Development of Disease-Modifying Therapeutics[J].Drugs,2019,79(8):797-810.DOI:10.1007/s40265-019-01104-1.
• [28] CHRISTINE C W,AUINGER P,JOSLIN A,et al.Vitamin B12 and Homocysteine Levels Predict Different Outcomes in Early Parkinson's Disease[J].Mov Disord,2018,33(5):762-770.DOI:10.1002/mds.27301.