L-acetylcarnitine treatment of mental decline in the elderly.
L-acetylcarnitine treatment of mental decline in the elderly.
复制标题
L-乙酰肉碱治疗老年人智力衰退。
DOI：
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
M. Neri
中科院分区：
文献类型：
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作者：
G. Salvioli;M. Neri
采用单盲临床试验方法，对44个老年和神经科的481名受试者进行了严格的筛选标准：年龄、简易精神状态检查（MMSE）总体恶化量表和老年抑郁量表（GDS）。在初始筛选和入组后，试验分四个阶段进行150天：T0阶段（安慰剂治疗30天），T1和T2阶段（L-乙酰肉碱（LAC）1500 mg/天，持续90天），T3阶段（安慰剂治疗30天）。根据从测试开始到结束发生的变化来评价药物疗效，所述测试评价整体和特定的认知表现，或情绪-情感和关系行为。T3期的结果使作者能够估计终止L-乙酰卡尼汀治疗后持续存在的可能的有利影响。通过MMSE评估的认知范围显示在LAC治疗结束时总分显著增加（p < 0.0001）。Randt记忆测验也显示LAC治疗改善了所测试的项目：总分和记忆指数显著增加，并且在LAC停止后保持了良好的效果。LAC治疗后GDS总分中情绪情感区有显著改善，汉密尔顿评定量表证实了这一积极结果（p < 0.0001）。通过家庭压力量表评估的行为-关系方面显示治疗后总分显著下降（p < 0.0004）;在不稳定和消极情绪评分中观察到相同的趋势。试验期间未发生明显的药物不良反应。总之，对老年人轻度精神损害的单盲、多中心试验数据的统计分析显示，LAC治疗期间和治疗后，几项性能均显著改善。其他报告表明，这种药物可能对治疗痴呆症有效。
A single-blind clinical trial was carried out on 481 subjects enrolled in 44 geriatric and neurologic units following a strict selection criteria: age, Mini Mental State Examination (MMSE) Global Deterioration Scale and Geriatric Depression Scale (GDS). After the initial screening and enrollment, the trial was run for 150 days in four phases: phase T0 (placebo treatment for 30 days), phases T1 and T2 (L-acetylcarnitine (LAC) 1500 mg/day for 90 days), phase T3 (further 30 days of placebo treatment). Drug efficacy was evaluated according to changes occurring from the beginning to the end of the tests which evaluate either whole and specific cognitive performances, or emotional-affective and relational behaviour. The outcome of phase T3 enabled the authors to estimate the possible favourable effects persisting after termination of L-acetylcarnitine therapy. The cognitive sphere evaluated by MMSE showed a significant increase in the total score at the end of LAC treatment (p < 0.0001). The Randt Memory Test also revealed that LAC treatment improved the items tested: the total score and the memory index increased significantly and the favourable effect persisted after LAC was discontinued. The emotional-affective area showed a significant improvement in the total score of the GDS after LAC therapy, and the positive results were confirmed by the Hamilton Rating Scale (p < 0.0001). The behavioural-relational aspects evaluated by the Family Stress Scale showed a significant decrease in the total score after treatment (p < 0.0004); the same trend was observed in the scores for instability and negative feeling. No significant adverse drug reaction occurred during the trial. In conclusion, the statistical analysis of the data from this single-blind, multicentre trial of mild mental impairment in the elderly showed a significant improvement of several performances during and after LAC treatment. Other reports indicate that this drug may be effective in the treatment of dementia.