目的 观察并探讨草酸艾司西酞普兰联合普拉克索治疗帕金森病患者非运动症状的临床疗效,并分析两组患者血生化指标及其相关性。方法 选取2017-01至2020-01解放军总医院第三医学中心收治的帕金森病患者72例,以给药种类不同分为对照组和试验组,每组36例。对照组患者给予帕金森常规治疗(多巴丝肼与普拉克索),试验组患者在对照组基础上加用小剂量草酸艾司西酞普兰片(10 mg/d)治疗。比较治疗前及治疗后1、2、3个月的汉密尔顿抑郁量表评分(HAMD)及帕金森病综合评分(UPDRS),测定并比较两组治疗前及治疗后3个月血清同型半胱氨酸(HCY)、胱抑素C(CysC)及尿酸(UA)水平。结果 试验组用药3个月后,HAMD评分为(12.98±1.92)分,UPDRSⅢ评分为(15.77±2.04)分,均低于对照组,差异有统计学意义(P<0.05);试验组用药3个月后血清HCY为(12.50±3.84)μmol/L,CysC为(0.70±0.10)mg/L,UA为(312.17±54.21)μmol/L,血清 HCY和 CysC的水平均低于对照组,尿酸的水平高于对照组,差异有统计学意义(P<0.05)。结论 给予小剂量草酸艾司西酞普兰联合普拉克索治疗帕金森病,可缓解患者非运动症状,调节相关血液学指标水平。
Abstract
Objective To explore the clinical effects of escitalopram combined with pramipexole on patients with non-motor symptoms of Parkinson’s disease and its effects on serum biochemical markers.Methods Seventy-two patients with Parkinson‘s disease from Jan. 2017 to Jan. 2020 were extracted to be divided into the control group and the observation group according to the type of administration, with 36 cases in each group. The control group was treated with Levodopa and Benserazide Hydrochlo-ride (madopar) and pramipexole, while the observation group received escitalopram (10 mg/d) on the basis of the control group. The scores of Hamilton depression scale (HAMD), unified Parkinson’ s disease rating scale (UPDRS) Ⅲ, serum biochemical markers, and the clinical efficacy of two groups were observed.Results After 3 months of treatment in the observation group,the HAMD scores were(12.98±1.92),the UPDRS Ⅲscores were (15.77±2.04),the concentration of HCY were(12.50±3.84)μmol/L, the concentration of CysC were 0.70±0.10)mg/L, and the concentration of UA were(312.17±54.21)μmol/L. The UPDRS Ⅲ, HAMD scores, HCY and Cys C were significantly lower than those of the control group, while the UA level was higher than control group, and the differences were statistically significant (P<0. 05).Conclusions Escitalopram combined with pramipexole can effectively improve the clinical symptoms of patients with Parkinson’s disease, and regulate the levels of hematological parameters related to non-motor symptoms.
关键词
草酸艾司西酞普兰 /
普拉克索 /
帕金森病 /
血清同型半胱氨酸 /
血清胱抑素C /
尿酸
Key words
escitalopram /
pramipexole /
parkinson’s disease /
homocysteine /
cystatin C /
uric acid
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Titova N, Qamar M A, Chaudhuri K R. The non motor features of Parkinson’s disease [J]. Int Rev Neurobiol, 2017,132(7):33-54.
[2] Kim R, Shin J H, Park S, et al. Longitudinal evolution of non-motor symptoms according to age at onset in early Parkinson’s disease[J]. J Neurol Sci, 2020,418(3): 117157.
[3] Huot P, Fox S H, Brotchie J M. The serotonergic system in Parkinson’s disease[J].Prog Neurobiol, 2011, 95(2):163-212.
[4] 刘 军.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.
[5] Schrag A, Horsfall L, Walters K, et al. Prediagnostic presentations of Parkinson’s disease in primary care: a case-control study[J]. Lancet Neurol, 2015,14(1):57-64.
[6] Lee M, Ryu Y H, Cho W G, et al. Relationship between dopamine deficit and the expression of depressive behavior resulted from alteration of serotonin system[J].Synapse, 2015, 69(9):453-460.
[7] Weintraub D, Aarsland D, Chaudhuri K R.The neuropsychiatry of Parkinson's disease: advances and challenges[J]. Lancet Neurol,2022,21(1):89-102.
[8] Ortiz L A,Ramos R G,Grandas F J, et al.Focus on depression in Parkinson’s disease: a delphi consensus of experts in psychiatry, neurology, and geriatrics [J]. Prakinsons Dis,2021,21(2):6621991.
[9] Cao Y, Li G F,Xue J,et al. Depression and related factors in patients with Parkinson’s disease at high altitude[J].Neuropsychiatr Dis Treat,2021,17(6):1352-1362.
[10] Ramezani M, Ruskey JA, Martens K, et al.Association between BDNF Val66met polymorphism and mild behavioral impairment in patients with Parkinson’s disease [J]. Front Neurol,2021,11(1):58-79.
[11] Saari L, Heiskanen L, Gardberg M, et al. Depression and nigral neuron density in lewy body spectrum diseases[J]. Ann Neurol,2021,89(5): 1046-1050.
[12] Chen H, Wan H, Zhang M, et al. Cerebral small vessel disease may worsen motor function, cognition, and mood in Parkinson’s disease[J]. Parkinsonism Relat Disord, 2021,83(1): 86-92.
[13] Picillo M, Palladino R, Erro R, et al. The Priamo study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson’s disease[J]. J Neurol, 2021,268(2): 448-454.
[14] Barnett R. Parkinson’s disease [J].Lancet, 2016, 387(10015):217.
[15] Bhattacharjee N, Paul R, Giri A, et al. Chronic exposure of homocysteine in mice contributes to dopamine loss by enhancing oxidative stress in nigrostriatum and produces behavioral phenotypes of Parkinson’s disease[J]. Biochem Biophys Rep, 2016, 6(7):47-53.
[16] Liao X, Zhu Y, Xue C. Diagnostic value of serum cystatin C for diabetic nephropathy: a meta-analysis[J]. BMC Endocr Disord,2022,22(1):149.
[17] Yu Z, Zhang S, Wang D, et al. The significance of uric acid in the diagnosis and treatment of Parkinson disease: an updated systemic review [J]. Medicine, 2017, 96 (45):e8502.
PDF(957 KB)
