| Objective: To evaluate the population pharmacokinetics of Chinese patients taking levodopa. To make a shortcut Parkinson `s Table for Clinical use, and analyze the reliability and validity of this new table. To study the therapeutic effect of pramipexole in Parkinson `s Disease.Methods: 1.All patients came from Neurology department of the first affiliated hospital of Fujian medical university. We finally collected 51 samples, the software of NONMEM is used to evaluate the population pharmacokinetics parameters of levodopa. Moreover, we applied the way of interior verification to test the model.2.Choose part of the items from United Parkinson `s Table to form a new table both from the clinical way and the statistics way. This new table is divided into four parts: the first part is about sprit, behavior, and emotion; the second part concerns about daily life; the third part is for the ability of movement,;and the final part refers to the side effect of therapy. The table has 28 items totally, each item has five ranks and it is marked from 0 to 4. We choose nearly 99 patients mainly from the first affiliated hospital of Fujian Medical university, evaluate the condition of their disease with United Parkinson `s Table and Shortcut Parkinson `s Table. We apply correlation coefficient of Pearson to analyze the items of Shortcut Parkinson `s Table. The indexs like the numerical value of reliability of cronbach `s alpha and Guttman-half are used to detect the reliability of United Parkinson `s Table and Shortcut Parkinson `s Table. Correlation coefficient of Pearson is computed to evaluate content validity of Shortcut Parkinson `s Table. Analyze the relationship of these two tables is to help evaluate the validity of structure of Shortcut Parkinson `s Table. The measure of analyzing Correlation coefficient of Spearman rank is to help compute the relationship between Hoehn&Yahr Rank and the new table. The statistics way of one-factor analysis of variance is to analyze the groups of Parkinson `s patients in the different stage of Hoehn&Yahr Rank.3.Forty patients with Parkinson `s Disease were treated with pramipexole for twelve weeks and evaluated with UDPRS table pre- and post- therapy.Result: 1.It is found that age and daily dose of MDB for per surface area significantly influences the clearance of levodopa. The final model is: CL=1.92×AGE+0.312×MDBS+0.005。2.All patients are included in the study.①Item Analyze: Correlation coefficient of every item of Shortcut Parkinson `s Table reaches to 0.262～0.825, The numerical value of CR has significant meaning(P<0.01).②Test of reliability: Comparing with United Parkinson `s Table, although Shortcut Parkinson `s table has less items, the numerical value of reliability of cronbach `s alpha of each item has no significant difference, all reach above 0.6,while the numerical value of reliability of Guttman-half has no significant difference either, and all reach above 0.6.③Test of validity: Except the 28th item, correlation coefficient of items in shortcut Parkinson `s Table more relates to its own part than other parts, and every part of shortcut Parkinson `s Table collates to all parts of United Parkinson `s Table strongly, the correlation coefficient reaches to 0.513～1.000.④Except the first part, correlation coefficient of Spearman rank of the other parts of Shortcut Parkinson `s Table and Hoehn&Yahr Rank is above 0.55.⑤Use the statistics measure of one-factor analysis of variance to analyze the patients in the different stage of Hoehn&Yahr Rank, there are significant difference between different ranks(P<0.01).3.After the therapy of pramipexole, the symptom of Parkinson `s Disease alleviated in 35 patients. The percentage of alleviation reachs to 87.5%, The value of UDPRS decreased in most of the patients. In the process of follow-up, we can find that patients become better in all aspects of pathogenetic condition.Conclusion: 1.According to the model of the population pharmacokinetics of Chinese patients taking levodopa, we can evaluate the clearance of patients and formulate the dosage regimen of individualization for every patient.2.Comparing with United Parkinson `s Table, Shortcut Parkinson `s Table has less items, but it remains all around clinical meaning. It has highly clinical and statistics meaning. It is worthy clinical generalization and it worthy need more study.3.The results suggest that there are significant therapeutic effects of Sirfol for Parkinson, s disease. It is a safety and good effctive anti-parkinson drug. |
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