Efficacy of levodopa and benserazide combined with pramipexole on patients with Parkinson's disease and its influence on cognitive function and oxidative stress indicators
10.3760/cma.j.cn101721-20240417-00122
- VernacularTitle:多巴丝肼联合普拉克索治疗帕金森病患者的效果及对认知功能、氧化应激指标的影响
- Author:
Jianping PAN
1
;
Yun ZHANG
;
Wenyu TANG
;
Xuan MA
Author Information
1. 西安国际医学中心医院神经重症康复中心，西安 710100
- Keywords:
Parkinson's disease;
Levodopa and benserazide;
Pramipexole
- From:
Clinical Medicine of China
2024;40(5):357-363
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of levodopa and benserazide combined with pramipexole in the treatment of Parkinson's disease (PD) and its influence on cognitive function and oxidative stress indicators.Methods:From January 2021 to December 2023, the clinical datas of 110 PD patients in the Neurocritical Rehabilitation Center of Xi'an International Medical Center Hospital were selected for a prospective study. Based on the principle of balanced and comparable baseline features between groups, they were divided into single drug group (odd number, 55 cases, oral levodopa and benserazide, effective dose: 500-1 000 mg/d) and combined group (even number, 55 cases, pramipexole based on single drug group, effective dose: 0.375-4.500 mg/d) according to the simplified randomization method (odd-even number method). The therapeutic effect (Unified Parkinson's Disease Rating Scale (UPDRS)), improvement status of symptoms, cognitive ability (Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA)), oxidative stress indicators (superoxide dismutase (SOD), malondialdehyde) and brain injury indicators (central nervous system specific protein β (S100β), human Parkinson protein 7 (PARK7)) before and after treatment and adverse drug reactions were compared between groups of patients.Results:After treatment, the scores of UPDRS Ⅰ, Ⅱ and Ⅲ dimensions in the two groups were significantly decreased, and the above scores with ((5.53±1.16, 20.43±3.98, 14.37±3.07) points) in combined group were significantly lower than ((7.06±1.64, 24.56±4.37, 17.32±3.83) points) in single drug group ( t values were 5.65, 5.18 and 4.46, respectively; all P<0.001). After treatment, the autonomic disorder and sensory disturbance were significantly improved in both groups, but the proportion of sensory disturbance after treatment in combined group (20.00%, 11/55) was significantly lower than that in single drug group (38.18%, 21/55), and the difference was statistically significant ( χ2=4.41, P=0.036). The MMSE score in the two groups after treatment was decreased significantly while the MoCA score was increased significantly, but the MMSE score in combined group with ((10.38±1.95) points) was significantly lower than ((12.27±2.26) points) in single drug group. The difference was statistically significant ( t=4.70, P<0.001) while the MoCA score with ((18.46±3.21) points) was significantly higher compared with ((16.84±3.07) points) in single drug group.The difference was statistically significant ( t=2.71, P=0.008). After treatment, SOD in the two groups was risen significantly while malondialdehyde was declined significantly, and SOD in combined group with ((82.53±10.63) U/L) was significantly higher than ((76.54±8.85) U/L) in single drug group, while malondialdehyde with ((4.64±0.85) μmol/L) was significantly lower than ((6.46±1.26) μmol/L) in single drug group. The difference is statistically significant ( t values were 3.21 and 8.88, respectively; P values were 0.002 and <0.001). The levels of S100β and PARK7 in both groups were reduced significantly after treatment, and the combined group ((73.64±5.72) ng/L, (78.04±6.93) μmol/L) had significantly lower levels than the single drug group ((15.73±3.25) ng/L, (22.23±3.84) μmol/L). The differences were statistically significant ( t-values were 3.63 and 9.58, respectively; both P<0.001). There was no statistical difference in incidence of adverse drug reactions between groups ( P>0.05). Conclusion:Levodopa and benserazide combined with pramipexole can enhance the cognitive function of PD patients and improve the oxidative stress indicators, with few adverse reactions, safe and effective, and is worthy of application.
