Short-term effects of high-dose 17β-estradiol in postmenopausal PD patients -: A crossover study
Short-term effects of high-dose 17β-estradiol in postmenopausal PD patients -: A crossover study
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DOI：
10.1212/wnl.53.1.91
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发表时间：
1999-07-13
期刊：
影响因子：
9.9
通讯作者：
Chase, TN
中科院分区：
文献类型：
--
作者：
Blanchet, PJ;Fang, J;Chase, TN
目的：探讨17 - β -雌二醇对绝经后妇女帕金森病主要症状严重程度的影响。背景：虽然雌激素对PD表现的影响尚未得到严格的研究，但通常认为雌激素的使用与有害的抗多巴胺能作用有关。方法：一项双盲、安慰剂对照、双臂交叉研究对8名患有轻度至中度PD的绝经后妇女进行了高剂量经皮17 β -雌二醇的研究，除1人外，其余均表现出左旋多巴诱导的运动障碍。患者最初随机接受激素治疗或安慰剂治疗2周，随后是2周的洗脱期，然后是另外2周的交叉治疗期。积极治疗采用四个皮肤贴片，每个贴片每天释放0.1毫克雌二醇，每2至3天更换一次。结果：治疗10天后，观察到静脉左旋多巴的抗帕金森阈值剂量显著降低，左旋多巴阈值或高剂量的抗帕金森反应的平均持续时间和强度不变，与安慰剂相比，17 β -雌二醇治疗期间运动障碍评分没有改变。雌激素治疗的“开启”时间和运动评分没有恶化的记录。结论：17 -雌二醇似乎显示出轻微的前多巴胺能（或抗帕金森）作用，但没有持续改变运动障碍。经皮17 -雌二醇的标准绝经后替代疗法可能对许多女性帕金森患者具有良好的耐受性。
Objective: To examine the effect of 17 beta-estradiol on the severity of the cardinal signs of PD in postmenopausal women. Background: Although the impact of estrogens on the manifestations of PD has not been subjected to rigorous study, their use is generally thought to be associated with a detrimental antidopaminergic effect. Methods: A double-blind, placebo-controlled, two-arm crossover study of high-dose transdermal 17 beta-estradiol was conducted in eight postmenopausal women with mild to moderate PD, all but one of whom exhibited levodopa-induced dyskinesias. Patients were randomized initially to either hormonal treatment or placebo for 2 weeks, followed by a 2-week washout period, and then another 2-week crossover treatment period. Active treatment employed four skin patches each releasing 0.1 mg of estradiol daily, replaced every 2 to 3 days. Results: After 10 days of treatment a significant reduction was observed in the antiparkinsonian threshold dose of IV levodopa, Mean duration and magnitude of the antiparkinsonian response to threshold or high doses of levodopa were unchanged, and dyskinesia scores were unaltered during 17 beta-estradiol treatment compared with placebo. No worsening in "on" time or motor ratings with estrogen treatment was documented. Conclusions: 17 beta-estradiol appears to display a slight prodopaminergic (or antiparkinsonian) effect without consistently altering dyskinesias. Standard postmenopausal replacement therapy with transdermal 17 beta-estradiol is likely to be well tolerated by many female parkinsonian patients.