用巴比他 (phenobarbital) 预先治疗是否可以预防患有精髓震的患者对普里米的急性不耐受性?
Stefano Calzetti1, Lucia Zinno2, Enrico Sasso2
1Neurology Unit, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci, 14, Parma, 43126, Italy. stefano.calzetti@unipr.it.
概括
预先用Phenobarbital (PB) 治疗基本震患者,可显著降低对Primidone (PMD) 的急性不耐受性. 这种策略尽量减少副作用,使PMD成为一种更安全的基本震的第一线治疗选择.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 普里米 (PMD) 是治疗基本震 (ET) 的首要疗法.
- 最初的PMD剂量可能会导致急性神经毒性副作用.
研究的目的:
- 评估ET患者急性PMD不耐受性的患病率.
- 评估巴比他 (PB) 前期治疗对PMD不耐受性的保护作用.
主要方法:
- 追溯性研究,比较ET患者的PMD不耐受性,有或没有先前的PB暴露.
- 在PB前期治疗中,每天服用10毫克,持续2-3周.
- 使用视觉模拟尺度测量了不耐受性和严重程度.
主要成果:
- 82%未接触PB的患者出现了不耐受性,而接受PB前治疗的患者为17% (p=0.0002).
- 预先治疗PB导致每名患者的副作用较少,严重程度得分较低.
- 在没有PB前治疗的情况下,有两名不耐受PMD的患者在PB前治疗后容忍了PMD.
结论:
- 费诺巴比特前期治疗有效地减少ET患者对普里米的急性不耐受性.
- 这表明一个功能性的交叉耐受性机制.
- 建议提供PB预治疗,以治疗PMD治疗的ET患者,特别是如果先前发生了不耐受.
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