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在阿尔茨海默氏症疾病中的塔克林
S A Eagger1, R Levy, B J Sahakian
1Institute of Psychiatry, Denmark Hill, London, UK.
Lancet (London, England)
|April 27, 1991
概括
塔克林 (四胺氨基丁) 结合莱西丁显著改善了阿尔茨海默病患者的认知功能,通过MMSE和AMTS测量. 虽然注意到肝酶升高等副作用,但认知效益却很大.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 阿尔茨海默病 (AD) 是一种进展性神经退行性疾病,其特点是认知能力下降.
- 塔克林 (tetrahydroaminoacridine) 是一种用于AD治疗的乙胆酶抑制剂.
- 莱西丁是一种脂补充剂,有时用于辅助.
研究的目的:
- 为了评估在可能患有阿尔茨海默氏症的患者中塔克林加上莱西丁的疗效和安全性.
- 用随机,双盲,交叉设计来比较活性治疗与安慰剂的影响.
主要方法:
- 一项随机,双盲,安慰剂控制的交叉研究,涉及89名可能患有AD的患者.
- 患者接受了13周的最大耐受剂量塔克林 (高达150毫克/天) 加上莱西丁 (10.8克/天) 或安慰剂,随后进行4周的洗,然后进行交叉治疗.
- 认知评估包括迷你心理状态检查 (MMSE),简体心理测试得分 (AMTS) 和护理人员对日常生活活动 (ADL) 的评分.
主要成果:
- 与安慰剂相比,塔克林加上莱西丁在MMSE得分上表现出显著的有益作用 (p < 0.0001),其中45%的患者表现出改善.
- 在AMTS分数 (p = 0.0001) 中也观察到类似的显著改善.
- 对于ADL得分,没有发现显著的治疗效应. 肝酶的剂量依赖,可逆升高是常见的.
结论:
- 塔克林加上莱西丁在阿尔茨海默病患者中提供了显著的认知益处,相当于6-12个月的疾病进展减缓.
- 治疗对关键认知指标产生了积极影响,尽管个体反应各不相同.
- 虽然肝酶升高令人担忧,但它们是可逆的,临床相关性需要个人判断.
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