普拉克索对老年血管性帕金森患者非运动症状及氧化应激的影响

Effect of Pramipexole on Non-motor Symptoms and Oxidative Stress in Elderly Patients with Vascular Parkinsonism

关键词:  普拉克索  老年  血管性帕金森综合征  非运动症状  氧化应激

Key words:  pramipexole  elderly  vascular parkinsonism  non-motor symptoms  oxidative stress

摘要:

目的 探讨普拉克索对老年血管性帕金森综合征（vascular parkinsonism，VP）患者非运动症状及氧化应激的影响。方法 纳入2015年1月—2016年6月于宁波市奉化区人民医院接受治疗的96例老年VP患者，按照随机化原则分为2组，各48例。2组均接受抗凝、改善循环、神经营养治疗，观察组在此基础上应用普拉克索，对照组应用美多芭片。分别于治疗前、治疗12月时测评患者统一帕金森病评定量表（UPDRS）、汉密尔顿抑郁量表（HAMD）、社会功能活动问卷（FAQ）、匹兹堡睡眠质量指数量表（PSQI）评分变化情况，并统计肢体感觉异常、自主神经症状发生情况，同时采集患者空腹静脉血，检测血清丙二醛、同型半胱氨酸、血钙、对氧磷酶-1水平。结果 2组治疗前UPDRS、HAMD、FAQ、PSQI量表评分，血清丙二醛、同型半胱氨酸、血钙、对氧磷酶-1水平均接近，组间差异无统计学意义。治疗后上述指标均有所改善，且观察组UPDRS各部分得分、HAMD和FAQ得分、PSQI各维度得分均显著低于对照组（P<0.05），丙二醛、同型半胱氨酸水平显著低于对照组（P<0.05），对氧磷酶-1水平显著高于对照组（P<0.05）。观察组治疗期间肢体感觉异常、自主神经症状发生率显著低于对照组（P<0.05）。结论 普拉克索能够有效改善老年VP患者非运动症状，抑制氧化应激损伤，对老年VP患者疗效更优。

Abstract:

OBJECTIVE To investigate the effect of pramipexole on non-motor symptoms and oxidative stress in elderly patients with vascular parkinsonism (VP). METHODS A total number of 96 elderly patients with VP who were treated in Fenghua People's Hospital of Ningbo from January 2015 to June 2016 were randomly divided into 2 groups, each of 48 cases. Two groups were treated with anticoagulation, circulation improvement and nerve nutrition therapy, and on this basis, the observation group was treated with pramipexole, while the control group was treated with madopar. Before treatment and at 12 months after treatment, the changes of unified Parkinson's disease rating scale (UPDRS), Hamilton depression scale (HAMD), functional activities questionnaire (FAQ) and pittsburgh sleep quality index (PSQI) were tested and evaluated; the conditions of abnormal body feeling and autonomic nerve symptoms were counted, at the same time, fasting blood in patients were collected to detect the changes of serum malondialdehyde (MDA), homocysteine (Hcy), serum calcium and paraoxonase-1 (PON-1) in 2 groups. RESULTS Before treatment, the scores of UPDRS, HAMD, FAQ and PSQI, and the expression of MDA, Hcy, calcium and PON-1 in serum of 2 groups showed no significant differences. After treatment, the above indexes were significantly better than those before treatment in two groups, and the scores of UPDRS, HAMD, FAQ, PSQI in the observation group were significantly lower than those in the control group (P<0.05), the levels of MDA and Hcy were significantly lower than those in the control group (P<0.05), PON-1 was significantly higher than that in the control group (P<0.05). The incidences of abnormal body feeling and autonomic nerve symptoms in the observation group were significantly lower than those in the control group (P<0.05). CONCLUSION Pramipexole can effectively improve non-motor symptoms and inhibit oxidative stress injury in elderly patients with VP, which may contribute to the better clinical outcomes.