Effect of Acute Levodopa Up-Titration on Blood Pressure in Patients With Early Stage Parkinson's Disease: Results of a Levodopa Challenge Test.
Effect of Acute Levodopa Up-Titration on Blood Pressure in Patients With Early Stage Parkinson's Disease: Results of a Levodopa Challenge Test.
复制标题
急性左旋多巴滴定对早期帕金森病患者血压的影响：左旋多巴激发试验的结果
DOI：
10.3389/fnagi.2021.778856
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发表时间：
2021
影响因子：
4.8
通讯作者：
Xiao Q
中科院分区：
文献类型：
--
作者：
He X;Mo C;Zhang Y;Cai Y;Yang X;Qian Y;Xiao Q
目的：左旋多巴剂量上调是帕金森病（PD）的主要治疗策略。然而，左旋多巴上调对血压（BP）的影响尚无定论。本研究旨在探讨左旋多巴激发试验（LCT）模拟左旋多巴急性剂量上调对早期PD患者血压的影响。方法：采用标准化站立试验对52例早期PD患者进行血压监测。在休息10分钟后和站立后1分钟和3分钟，在仰卧位评估BP。在医院LCT检查中，于早晨“关闭状态”和最佳“开启状态”下测量血压。另一天，在家中测量早晨服用抗PD药物前后的“关闭状态”和最佳“开启状态”血压。对患者的人口统计学和临床特征进行评估和分析。结果：在LCT中，在“关闭状态”和最佳“打开状态”下的OH患病率分别为11.5%和13.5%。此外，最佳“开状态”中的OH与“关状态”中的OH和单胺氧化酶B抑制剂的使用相关。尽管38例（73.1%）患者在LCT期间发生了左旋多巴诱导的低血压，但未发现风险因素。虽然在家中服用抗PD药物后观察到BP降低，但在LCT模拟的急性左旋多巴上调期间未观察到进一步降低。结论：我们的研究结果表明，急性左旋多巴剂量上调不会加剧在家抗PD药物引起的血压下降。血压监测对于PD患者的管理至关重要。
Objective: Levodopa up-titration is the primary therapeutic strategy as the Parkinson’s disease (PD) progresses. However, the effects of levodopa up-titration on blood pressure (BP) are inconclusive. This study aimed to investigate the effect of acute levodopa up-titration simulated by levodopa challenge test (LCT) on BP in patients with early stage PD. Methods: We monitored BP in 52 patients with early stage PD using a standardized standing test. BP was assessed in supine position after 10 min of rest and at 1 and 3 min after standing up. BP was measured in the “off-state” and the best “on-state” during LCT in the morning at hospital. In another day, “off-state” and the best “on-state” BP was measured before and after anti-PD drug uptake in the morning at home. Demographic and clinical features of the patients were evaluated and analyzed. Results: In the LCT, the prevalence of OH in the “off-state” and the best “on-state” was 11.5 and 13.5%, respectively. Additionally, the OH in the best “on-state” was associated with OH in the “off-state” and monoamine oxidase B inhibitor use. Although 38 (73.1%) patients experienced levodopa-induced hypotension during the LCT, no risk factors were identified. While BP reductions were observed after taking anti-PD drugs at home, no further reduction was seen during acute levodopa up-titration simulated by the LCT. Conclusion: Our results demonstrate that acute levodopa up-titration does not exacerbate BP reduction induced by anti-PD drugs at home. BP monitoring is critical for the management of patients with PD.
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影响因子：
4.1
作者：
Fabbri, Margherita;Coelho, Miguel;Ferreira, Joaquim J.
通讯作者：
Ferreira, Joaquim J.
影响因子：
--
作者：
Kujawa, K;Leurgans, S;Goetz, CG
通讯作者：
Goetz, CG
影响因子：
3.5
作者：
Pursiainen, V.;Korpelainen, T. J.;Myllyla, V. V.
通讯作者：
Myllyla, V. V.
影响因子：
8.6
作者：
Allcock, Liesl M.;Kenny, Rose Anne;Burn, David J.
通讯作者：
Burn, David J.
影响因子：
9.9
作者：
Fanciulli, Alessandra;Campese, Nicole;Wenning, Gregor K.
通讯作者：
Wenning, Gregor K.