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目的 根据左旋多巴（ＬＤ） 效应室浓度效应关系的差异探讨帕金森病（ＰＤ） 症状波动的发生原因和防治对策。方法 测定症状稳定（ＳＰ） 和症状波动（ＦＰ）ＰＤ 病人服单剂量ＬＤ 后的多时点血药浓度，同时动态观察相应的临床症状改善程度，根据Ｓｈｅｉｎｅｒ 效应室模型理论推导出两组病人的ＬＤ 效应室浓度药物效应的关系曲线，比较两者曲线参数的差异。结果 ＳＰ 和ＦＰ的ＬＤ 效应室浓度药物效应关系曲线的参数有较大的差异，ＥＣ５０ 、Ｈｉｌｌ 系数与病程、病级、ＬＤ 疗程正相关，Ｔ１／２ｅｑ与病程、病级、ＬＤ 疗程负相关。结论 ＬＤ 效应室药物浓度效应关系是研究ＰＤ 长期治疗后临床效应变化的有效方法。ＰＤ临床药效学变化规律对ＰＤ 症状波动的治疗有指导意义。
OBJECTIVE: To investigate the causes and control strategies of the fluctuation of symptoms of Parkinson’s disease (PD) according to the difference of the concentration-effect relationship of levodopa (LD) effect. Methods The multi-time plasma concentrations of single-dose LD after symptoms-stable (SP) and symptom-related fluctuations (FP) were measured and the corresponding clinical symptoms were observed dynamically. According to the Sheiner effect model, the LD Effect chamber concentration drug effect curve, the difference between the two curve parameters. Results There were significant differences in the parameters of LD and LD between the SP and FP. The EC50 and Hill coefficients were positively correlated with the course of disease, disease grade and LD regimen. T1 / 2eq was negatively correlated with the course of disease, disease grade and LD regimen . Conclusion LD concentration of drug concentration-effect relationship is an effective method to study the clinical effect of PD after long-term treatment. PD clinical pharmacodynamic changes in the treatment of PD symptoms have guiding significance.