Black R S, Barclay L L, Nolan K A, Thaler H T, Hardiman S T, Blass J P
Dementia Research Service, Cornell University Medical College, Burke Rehabilitation Center, White Plains, New York 10605.
J Am Geriatr Soc. 1992 Mar;40(3):237-44. doi: 10.1111/j.1532-5415.1992.tb02075.x.
To test the effect of pentoxifylline, a hemorheologic agent used to treat intermittent claudication, on the course of vascular dementia.
Randomized, double-blind, placebo-controlled, parallel group trial.
Outpatient tertiary care center.
64 patients meeting DSM-III criteria for multi-infarct dementia with modified Hachinski ischemic scores greater than or equal to 6, 38 of whom completed the trial.
Pentoxifylline (Trental) 400 milligram tablets three times daily vs placebo for 36 weeks.
Alzheimer's Disease Assessment Scale (ADAS).
Baseline demographic values and psychometric variables were similar in the placebo and control groups; endpoint statistical analysis was used to allow the use of data from all patients in this clinically high-risk group. For the total group, the slowing of deterioration did not reach statistical significance (by 2-tailed t test), as measured by scores on the total ADAS (P = 0.058) or on the cognitive (ADAS items 1-11; P = 0.064) or non-cognitive subscales (ADAS items 12-21; P = 0.234), although it was significant on the cognitive subscales excluding memory (ADAS items 2-6, 8-10; P = 0.036). For the subgroup of 40 patients who had CT and/or MRI evidence of stroke as well as meeting the other inclusion criteria, treatment with pentoxifylline was associated with significantly slower deterioration, as measured by the total ADAS (P = 0.023) and cognitive subscores (P = 0.020) but not non-cognitive subscores (P = 0.118). For the subgroup of 37 patients who had at least one discrete clinical stroke, treatment with pentoxifylline was associated with significantly less deterioration on the total ADAS (P = 0.002) and both the cognitive (P = 0.001) and non-cognitive (P = 0.017) subscores.
Treatment with pentoxifylline may slow the progression of dementia in patients who meet DSM-III criteria for "multi-infarct dementia" and who also have clinical and neuroradiological evidence of cerebrovascular disease.
测试己酮可可碱（一种用于治疗间歇性跛行的血液流变学药物）对血管性痴呆病程的影响。
随机、双盲、安慰剂对照、平行组试验。
三级门诊护理中心。
64名符合DSM - III多梗死性痴呆标准且改良Hachinski缺血评分大于或等于6的患者，其中38名完成了试验。
己酮可可碱（曲可芦丁）400毫克片剂，每日三次，与安慰剂对照，为期36周。
阿尔茨海默病评估量表（ADAS）。
安慰剂组和对照组的基线人口统计学值和心理测量变量相似；采用终点统计分析以便能够使用该临床高危组中所有患者的数据。对于整个组，根据ADAS总分（P = 0.058）、认知部分（ADAS项目1 - 11；P = 0.064）或非认知子量表（ADAS项目12 - 21；P = 0.234）的评分，恶化减缓未达到统计学显著性（通过双侧t检验），尽管在排除记忆的认知子量表（ADAS项目2 - 6、8 - 10；P = 0.036）上具有显著性。对于40名有CT和/或MRI中风证据且符合其他纳入标准的患者亚组，己酮可可碱治疗与显著减缓的恶化相关，根据ADAS总分（P = 0.023）和认知子评分（P = 0.020）衡量，但非认知子评分无显著差异（P = 0.118）。对于37名至少有一次明确临床中风的患者亚组，己酮可可碱治疗与ADAS总分（P = 0.002）以及认知（P = 0.001）和非认知（P = 0.017）子评分的显著恶化减缓相关。
己酮可可碱治疗可能会减缓符合DSM - III“多梗死性痴呆”标准且同时有脑血管疾病临床和神经放射学证据的患者的痴呆进展。
