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首页> 外文期刊>Journal of Behavioral and Brain Science >Continuous Apomorphine Infusion in Patients with Advanced Parkinson’s Disease with Varying Degrees of Functional Impairment
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Continuous Apomorphine Infusion in Patients with Advanced Parkinson’s Disease with Varying Degrees of Functional Impairment

机译：功能性受损程度不同的晚期帕金森病患者连续阿扑吗啡输注

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Introduction: Continuous apomorphine infusion (CAI) is effective in improving complications in advanced Parkinson’s disease (APD). The effectiveness and tolerance of CAI in patients with APD with varying degrees of functional impairment was studied. Methods: In this comparative observational study, consecutive APD who started treatment with CAI were included. They were classified into two groups of functional impairment: A) moderate (Schwab and England (S & E) = 60% - 80% and Hoehn and Yahr (H & Y) = 2 - 3; Group (A), and (B) severe (S & E 3; Group B). Clinical follow-up was performed with concomitant medication and CAI adjustment at 3, 6 and 12 months. Clinical evaluation included a dyskinesia diary and AIMS, S & E, NPI, NMSS and HADS questionnaires. Results: Eighteen patients participated (A = 9 and B = 9) with EP diagnosed 7 (A) and 13 (B) years before. Their baseline dose of levodopa was 728 mg (A) and 925 mg (B), which did not change during follow-up. Dopamine agonists were progressively reduced in both groups. Progressive titration of CAI resulted in abandonment of apomorphine bolus administration. Both groups experienced improvements in all variables, higher in group A; motor fluctuations = 69% (A), 53% (B); AIMS = 82% (A), 71 (B); S & E = 32% (A), 18% (B); NMS = 62% (A), 19% (B); NPI = 75% (A), 50% (B); HADS (anxiety) = 26% (A), 21% (B); HADS (depression) = 52% (A), 31% (B). Adverse effects were generally mild and resolved without reducing CAI dose. There were no withdrawals. Conclusions: Patients with APD and moderate functional impairment treated with CAI may obtain greater functional, cognitive and emotional improvement than patients more severely affected.
机译：简介：连​​续阿朴吗啡输注（CAI）可有效改善晚期帕金森病（APD）的并发症。研究了功能障碍程度不同的APD患者的CAI有效性和耐受性。方法：在这项比较观察性研究中，包括开始用CAI治疗的连续APD。他们分为两类功能障碍：A）中度（Schwab和England（S＆E）= 60％-80％和Hoehn和Yahr（H＆Y）= 2-3）;（A）组，和（B严重（S＆E 3; B组），在3、6和12个月时进行伴随药物和CAI调整的临床随访，包括运动障碍日记和AIMS，S＆E，NPI，NMSS和HADS结果：18例患者（A = 9和B = 9）参加了7年前（A）和13（B）确诊的EP，其左旋多巴的基线剂量为728 mg（A）和925 mg（B），两组间的多巴胺激动剂均逐渐减少，CAI的逐步滴定导致放弃了阿扑吗啡的推注，两组的所有变量均有改善，A组较高;运动波动= 69％（A） ，53％（B）; AIMS = 82％（A），71（B）; S＆E = 32％（A），18％（B）; NMS = 62％（A），19％（B）; NPI = 75％（A），50％（B）; HADS（焦虑）= 26％（A），21％ （B）; HADS（抑郁）= 52％（A），31％（B）。不良反应通常是轻微的，并且在不降低CAI剂量的情况下得以缓解。没有提款。结论：与受影响较严重的患者相比，接受CAI治疗的APD和中度功能障碍的患者可能获得更大的功能，认知和情绪改善。

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