Faktori rizika od diskinezija uzrokovanih levodopom kod obolelih od Parkinsonove bolesti

  • Gordana M Djurić Railway Health Care Institute, Belgrade, Serbia
  • Vladana Marković Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Tatjana Pekmezović Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia
  • Aleksandra Tomić Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Nikola Kresojević Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Vladimir Kostić Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
  • Marina Svetel Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP150723264D
Ključne reči: parkinson disease||, ||parkinsonova bolest, disease progression||, ||bolest, progresija, levodopa||, ||levodopa, dyskinesia, drug-induced||, ||diskinezija izazvana lekovima, risk factors||, ||faktori rizika, surveys and questionnaires||, ||ankete i upitnici,

Sažetak


Uvod/Cilj. Levodopa, prekursor dopamine pretstavlja supstitucionu terapiju Parkinsonove bolesti. Dugotrajna upotreba levodopa uzrokuje fluktacije motornog odgovora i pojavu neželjenih pokreta ili diskineziju. Cilj rada bio je procena značaja faktora rizika od razvoja diskinezija uzrokovanih levodopom kod obolelih od Parkinskonove bolesti (PB). Metode. Istraživanje je obuhvatilo 177 bolesnika sa PB, regrutovanih na Neurološkoj klinici Kliničkog centra Srbije (Beograd), čije lečenje je trajalo duže od šest meseci. Za ispitivanje obolelih korišćene su standardizovane skale za kvantifikovanje PB, ali i detaljni posebno konstruisani upitnik za ovu studiju sa demografskim i kliničkim podatcima. Rezultati. Bolesnici sa diskinezijama (n = 50) bili su mlađi na početku bolesti i imali su duže trajanje bolesti. Takođe, oboleli sa diskinezijama imali su veće skorove na Unified Parkinson's Disease Rating Scale (UPDRS), učestalije motorne komplikacije – fluktuacije terapijskog odgovora (bilo u formi skraćenja trajanja pojedinačnih doza (“wearing off”) ili motornih blokova hoda (“freezing”) i češće su ispoljavali medikamentoznu psihozu. Oni su bili i na statistički višim dozama levodope, ali i višoj ekvivalentnoj dozi levodope, pri čemu je njihovo lečenje trajalo značajno duže. Multivarijantna analiza pokazala je da su nezavisni prediktori pojave diskinezija u grupi bolesnika sa PB bili: dužina bolesti preko 10 godina [relativni rizik (RR = 2.90, 95% interval poverenja (IP) 1.19–7.10; p = 0.019), dužina terapije više od 94 meseci (RR = 3.21, 95%IP 1.05–9.87; p = 0.041), dnevna doza levodope u trenutku ispitivanja veća od 537 mg (RR = 3.62, 95%IP 1.57–8.35; p = 0.002). Zaključak. Potvrđen je značaj poznatih faktora rizika od razvoja diskinezija u odmakloj fazi Parkinsonove bolesti.

Biografija autora

Gordana M Djurić, Railway Health Care Institute, Belgrade, Serbia
drc sci med, specijalista neurologije

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Objavljeno
2017/10/27
Broj časopisa
Vol. 74 Br. 10 (2017)
Rubrika
Originalni članak