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4左旋多巴和疾病进展目前人们普遍认识到左旋多巴明显改善了帕金森病运动不能的进展和病死率,但在对左旋多巴抵抗的不典型帕金森综合征患者中无此结果。Hoehn比较了左旋多巴出现前后每5年间的病死率和致残率(Hoehn&Yahr评分Ⅳ和Ⅴ级)的差异,结果发现,左旋多巴减少同期患者运动不能的发生率多达50%。然而,在治疗和未治疗的患者间,疾病的进展差异无显著性。该结果表明左旋多巴并不阻止帕金森病的进展。此外,左旋多巴不能影响肢体受累的模式,包括从一侧上肢或下肢随时间进展累及到对侧或其他肢体。
4 Levodopa and Disease Advances It is now widely recognized that levodopa has significantly improved the progression and mortality of Parkinson’s disease, but not in patients with atypical Parkinson’s disease resistant to levodopa. Hoehn compared differences in mortality and morbidity (Hoehn & Yahr scores IV and V) every 5 years before and after levodopa, and found that levodopa reduced as much as 50% of patients with motor exacerbation during the same period. However, there was no significant difference in the progression of the disease between treated and untreated patients. This result shows that levodopa does not prevent the progression of Parkinson’s disease. In addition, levodopa does not affect the patterns of limb involvement, including the development of contralateral or other limbs over time from one side of the upper or lower extremity.