多种多巴胺受体激动剂转换为普拉克索的疗效和安全性研究

目的观察多种多巴胺受体激动剂转换为普拉克索治疗帕金森病（PD）患者的疗效和安全性。方法35例PD患者入组研究。除7例单用其他多巴胺受体激动剂在1d内直接转换为普拉克索外，其余均在原用药基础上将其他多巴胺受体激动剂转换为普拉克索并逐渐加量。所有患者在用药前后按改良Webster症状评分量表和日常活动能力量表（ADL量表Barthel指数）进行评分，尽量每4周对患者进行随访评分1次，详细记录患者的总评分、日常活动能力评分、运动功能评分、震颤评分等各方面数据，并对患者年龄、性别、病程、用药等资料进行详细登记。整个观察时间为8周。结果有7例患者报道了6个不良事件。35例PD患者换药后改良Webster症状评分量袁和日常活动能力量表（ADL量表Barthel指数）评分值与换药前比较，差异均有统计学意义（P〈0．01）；换药后部分患者美多芭的剂量有所减少。普拉克索转换后的平均剂量为1．5mg／d。结论快速或逐量由其他多种多巴胺受体激动剂转化为普拉克索治疗帕金森病是安全的，临床症状和日常活动能力的改善可能与普拉克索的直接疗效以及安慰剂效应、美多巴的疗效有关。

Efficacy and Safety of Pramipexole Use Switched from Various Dopamine Receptor Agonists

Objective To determine the efficacy and safety of pramipexole use switched from various dopamine agonists (DA) in patients with advanced Parkinson's disease (PD). Methods A total of 35 PD patients were enrolled in this study. All patients received pramipexile switched from DA based on original medication and the amount increased gradually, except that 7 patients received pramipexile directly switched from DA within 1 d. All patients were scored by modified Webster Scales and Activities of Daily Living Scale (ADL) , and followed up every 4 weeks. Various data such as total scores, scores of daily activity ability, motor function and tremor were recorded in detail. The age, gender, disease courses and medication were registered. The observation lasted 8 weeks. Results Seven patients reported 6 adverse events. No serious side effects were found (respiratory arrest, dyskinesias, face edema and abdominal pains). A significant improvement was noted in assessed parameters (P<0.01). Mean madopar dosage decreased in 1/3 PD patients. The mean dosage of pramipexole was 1.3 mg/d. Conclusion Pramipexole use switched quickly or gradually from various DA is safe in treating PD. Improvement of clinical symptoms and daily activity ability may be associated with the direct effect of pramipexole and placebo effect and therapeutic effect of madopar.