2022 年第 1 期 第 17 卷

普拉克索联合艾地苯醌对帕金森病患者血清胰岛素样生长因子1和γ-氨基丁酸水平的影响

The effect of pramipexole combined with idebenone on serum levels of insulin-like growth factor-1 and gamma-aminobutyric acid in patients with Parkinson′s disease

作者：张卉王冬晓

英文作者：Zhang Hui Wang Dongxiao

单位：南京中医药大学第二附属医院江苏省第二中医院药学部，南京210000

英文单位：Department of Pharmacy the Second Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Second Hospital of Traditional Chinese Medicine Nanjing 210000 China

关键词：帕金森病；普拉克索；艾地苯醌；胰岛素样生长因子1

英文关键词：Parkinson′sdisease;Pramipexole;Idebenone;Insulin-likegrowthfactor-1

• 摘要：

• 目的 探讨普拉克索联合艾地苯醌对帕金森病患者血清胰岛素样生长因子1(IGF-1)和 γ-氨基丁酸(GABA)水平的影响。方法 选取2019年3月至2020年3月南京中医药大学第二附属医院收治的帕金森病患者96例，采用随机数字表法分为对照组和观察组，各48例。对照组给予艾地苯醌治疗，观察组在对照组治疗基础上联合多巴胺D2受体激动剂普拉克索治疗，2组均持续治疗2周。比较2组患者治疗前后血清炎症因子、氧化应激指标、多巴胺功能指标水平，血清IGF-1和GABA水平，临床疗效和不良反应发生率。结果 治疗前2组患者血清炎症因子、氧化应激指标和左右两侧纹状体多巴胺D2受体结合力水平比较差异均无统计学意义（均P＞0.05）；治疗后，2组炎症因子白细胞介素1β、肿瘤坏死因子α、γ-干扰素、白细胞介素6和丙二醛水平均低于治疗前，且观察组均低于对照组（均P＜0.05）；氧化应激指标谷胱甘肽过氧化物酶、超氧化物歧化酶和左右两侧纹状体多巴胺D2受体结合力均高于治疗前，且观察组均高于对照组（均P＜0.05）。治疗前2组患者血清IGF-1和GABA水平比较差异均无统计学意义（均P＞0.05）；治疗后2组患者血清IGF-1和GABA水平均高于治疗前，观察组均高于对照组［(168±53)ng/L比（142±44）ng/L，（272±87）mmol/L比（227±72）mmol/L］（均P＜0.05），且观察组临床总有效率高于对照组［95.8%(46/48)比79.2%（38/48）］（P=0.014），而2组不良反应发生率比较差异无统计学意义（P=0.371）。结论  多巴胺D2受体激动剂普拉克索联合艾地苯醌可有效升高帕金森患者血清IGF-1和GABA水平，减轻机体炎症、氧化应激反应，促进多巴胺功能，提高疗效。

• Objective   To investigate the effect of pramipexole combined with idebenone on serum levels of insulin-like growth factor-1 (IGF-1) and gamma-aminobutyric acid (GABA) in patients with Parkinson′s disease (PD). Methods  From March 2019 to March 2020, 96 patients with PD admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine were enrolled. They were randomly divided into control group and observation group, with 48 cases in each group. The control group was treated with idebenone, and the observation group was treated with dopamine D2 receptor agonist pramipexole on the basis of the control group. Both groups were treated for 2 weeks. Serum inflammatory factors, oxidative stress indexes, dopamine function indexes, serum IGF-1 and GABA levels, clinical efficacy and the incidence of adverse reactions were compared between the two groups before and after treatment. Results  Before treatment, there were no significant differences in levels of inflammatory factors, oxidative stress indexes and dopamine D2 receptor binding capacity in bilateral striatum between the two groups (all P>0.05); after treatment, the inflammatory factors such as interleukin-1β, tumor necrosis factor-α, interferon gamma, interleukin-6 and malondialdehyde levels in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P<0.05). The oxidative stress indexes such as glutathione peroxidase, superoxide dismutase and dopamine D2 receptor binding capacity in bilateral striatum were higher than those before treatment, and those in the observation group were higher than those in the control group (all P<0.05). There were no significant differences in serum IGF-1 and GABA levels between the two groups before treatment (both P>0.05); after treatment, the serum IGF-1 and GABA levels of the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group ［(168±53)ng/L vs (142±44)ng/L, (272±87)mmol/L vs (227±72)mmol/L］(all P<0.05), and the clinical total effective rate of the observation group was higher than that of the control group ［95.8%(46/48) vs 79.2%(38/48)］(P=0.014). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.371). Conclusion  Dopamine D2 receptor agonist pramipexole combined with idebenone can effectively increase serum IGF-1 and GABA levels in patients with PD, reduce inflammation and oxidative stress reactions, promote dopamine function and improve curative effect.