普拉克索联合左旋多巴治疗帕金森病的临床疗效及安全性

目的 探讨左旋多巴联合普拉克索治疗帕金森病的临床疗效及安全性。方法 选取2015年8月—2017年12月于南通市第一人民医院神经内科门诊或住院诊治的帕金森病患者150例,采用随机法分为观察组（80例）和对照组（70例）,对照组患者仅给予左旋多巴进行治疗,观察组患者给予左旋多巴联合普拉克索进行治疗,持续服药12周,比较两组患者帕金森病综合评估量表（UPDRS）Ⅱ和UPDRS Ⅲ、汉密顿抑郁量表（HAMD）及不良反应的发生率。结果 治疗前,两组患者的UPDRS Ⅱ和UPDRS Ⅲ评分相比,差异无统计学意义;经治疗后,两组患者UPDRS Ⅱ和UPDRS Ⅲ评分均显著降低,同组治疗前后比较差异有统计学意义（P<0.05）;与对照组相比,观察组患者UPDRS Ⅱ和UPDRS Ⅲ评分显著低于对照组,差异有统计学意义（P<0.05）。治疗后,两组患者的HAMD评分显著降低,同组治疗前后比较差异有统计学意义（P<0.05）;与对照组治疗后相比,观察组患者的HAMD评分显著降低,差异具有统计学意义（P<0.05）。观察组患者不良反应发生率为13例（16.25%）,对照组患者不良反应发生率为9例（12.86%）,差异无统计学意义。结论 左旋多巴联合普拉克索治疗帕金森病的临床疗效较好,且安全可靠。     

普拉克索治疗早期帕金森病的效果

目的观察多巴胺受体激动剂普拉克索对早期帕金森(PD)病人的治疗效果。方法选择早期PD病人60例,随机分成美多芭组和普拉克索组,两组病人从小剂量开始渐增加剂量至症状稳定后维持治疗,采用改良WEBSTER和帕金森统一量表(UPDRS)评分比较两组治疗1、3个月后的效果。结果普拉克索组治疗1月时改良的WEBSTER评分和UPDRS评分较治疗前无显著改善(P>0.05),改良WEBSTER评分3个月时较治疗前及1月时有显著改善(F=35.286,q=11.92、7.69,P<0.01);UPDRS评分3个月时较治疗前及1月时有显著改善(F=8.812,q=5.88、3.68,P<0.01)。美多芭组WEBSTER评分于治疗1、3个月后较治疗前均有显著改善(F=76.619,q=11.85、17.31,P<0.01);UPDRS评分于治疗1、3个月后较治疗前均有显著改善(F=39.032,q=9.34、11.85,P<0.01);WEBSTER评分和UPDRS评分治疗3个月时较治疗1月时无进一步改善(P>0.05)。美多芭组于治疗1、3个月时UPDRS评分改善均优于普拉克索组(t=3.767、3.347,P<0.01、0.05)。结论普拉克索能改善早期帕金森病人的临床症状,但普拉克索短期内在控制临床症状方面效果不及美多芭。     

普拉克索临床应用不良反应分析

目的探讨普拉克索致不良反应（ADR）的一般规律及特点,以提高临床用药的安全性。方法通过检索中国期刊全文数据库（CNKI）2007年1月—2012年7月间相关期刊文章,收集普拉克索ADR报道,并进行分类统计和分析。结果普拉克索所致ADR共137例,临床表现主要为神经系统和消化系统损害,所占比例分别为55.23%和40.12%;普拉克索所致ADR与患者年龄、给药剂量和联合用药等因素高度相关。结论普拉克索相关ADR的表现和危险因素复杂,临床用药应注意合理、安全和有效。     

Effects of different doses of dopamine receptor agonist pramipexole on neurobehaviors and changes of mitochondrial membrane potentials in rats with global cerebral ischemia-reperfusion injury

ObjectiveTo explore the effects of different doses of dopamine receptor agonist pramipexole on neurobehaviors and changes of mitochondrial membrane potential in rats with global cerebral ischemia-reperfusion injury.MethodsA total of 75 SPF Sprague-Dawley male rats were randomly divided into sham group (n=20), model group (n=20), pramipexole administration group (n=35). The rat model of global cerebral ischemia-reperfusion injury was prepared by the modified Pulsinelli's four-vessel occlusion method. Pramipexole administration group was administered intraperitoneally in rats with global cerebral ischemia-reperfusion injury at different doses of pramipexole 0.25 mg/kg, 0.5 mg/kg, 1 mg/kg, 2 mg/kg, once a day for 14 consecutive days. Based on the results of modified neurological severity scores, open field test and morphology by Nissl's staining to determine the optimal dose of pramipexole. Mitochondrial membrane potential in the optimal dose of pramipexole administration group were measured by the JC-1 fluorescent probe staining method.Results1. Different doses of pramipexole 0.25 mg/kg, 0.5 mg/kg, 1 mg/kg, and 2 mg/kg, were used as drug administration in rats with global cerebral ischemia-reperfusion injury for 14 consecutive days, and we found that all four doses of pramipexole could improve the modified neurological severity scores of rats with global cerebral ischemia-reperfusion injury to varying degrees, but only 0.5 mg/kg pramipexole at 1, 3, 7 and 14 days consistently reduced modified neurological severity scores and improved neurological function in rats with global cerebral ischemia-reperfusion injury. In the open-field test, only 0.5 mg/kg pramipexole increased the number of entries into the central zone, duration spent in the central zone, total distance travelled in the open field and average velocity, which improved the spontaneous activities and reduced anxiety and depression of rats with global cerebral ischemia-reperfusion injury. 2. Different doses of pramipexole 0.25 mg/kg, 0.5 mg/kg, 1 mg/kg, and 2 mg/kg for 14 consecutive days significantly increased the number of surviving neurons in the hippocampal CA1 subfield in rats with global cerebral ischemia-reperfusion injury to varying degrees. Based on these results, we tentatively found that 0.5 mg/kg pramipexole may be the optimal dose in all of the above. 3. We found that 0.5 mg/kg pramipexole significantly increased the mitochondrial membrane potential in rats after global cerebral ischemia-reperfusion injury.ConclusionDifferent doses of dopamine receptor agonist pramipexole improved neurological function of rats with global cerebral ischemia-reperfusion injury to varying degrees, and 0.5 mg/kg pramipexole may be the optimal dose in all of the above. Pramipexole may produce neuroprotective effects by protecting neurons in the hippocampus and improving the mitochondrial membrane potential after global cerebral ischemia-reperfusion injury.