The administration of guanidine in amyotrophic lateral sclerosis
The administration of guanidine in amyotrophic lateral sclerosis
复制标题
胍治疗肌萎缩侧索硬化症
作者：
F. Norris;P. Calanchini;R. Fallat;Sandra Panchari;Barbara Jewett
肌萎缩侧索硬化症患者的经验性治疗表明，在非家族性病例中，盐酸胍以至少10 mg/kg/天的剂量给药3个月或更长时间后，经典的下坡过程发生了一些改变。一项对照研究报告，在24名患者随机分配到胍剂量2或25毫克每公斤每天。到6个月时，接受较大剂量的组具有更稳定的疾病和更低的死亡率，但稳定病例的数量在10个月时失去了意义，并且没有患者显示出任何改善。肌萎缩侧索硬化症患者使用胍的任何短期益处都必须与可能的主要副作用（包括急性瘫痪和骨髓抑制）相平衡。此外，一个相对良性的过程，没有任何治疗是更有可能比过去认为的。
Empirical treatment of patients with amyotrophic lateral sclerosis suggested that some modification of the classical downhill course occurred in nonfamilial cases during administration of guanidine hydrochloride in dosages of at least 10 mg per kilogram per day for three months or more. A controlled study is reported in 24 patients assigned randomly to guanidine doses of 2 or 25 mg per kilogram per day. By six months the group receiving the larger dose had more stable disease and lower mortality, but the number of stable cases lost significance by 10 months and no patient showed any improvement. Any short-term benefit in ALS from the administration of guanidine must be balanced against possible major side effects, including acute paralysis and bone marrow depression. Also, a relatively benign course without any treatment is more likely than was thought in the past.