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[肌酸单水合物在肌营养不良患者中的临床试验]

[A clinical trial of creatine monohydrate in muscular dystrophy patients].

作者信息

Matsumura Tsuyoshi, Yokoe Masaru, Nakamori Masayuki, Hattori Noriaki, Saito Toshio, Nozaki Sonoko, Fujimura Harutoshi, Shinno Susumu

机构信息

Department of Neurology, National Hospital Organization Toneyama National Hospital.

出版信息

Rinsho Shinkeigaku. 2004 Oct;44(10):661-6.

PMID:15568480
Abstract

To investigate the effects of creatine monohydrate on muscle performance and cognitive functions in muscular dystrophy patients, we made an open trial. Twenty-nine individuals, including 14 myotonic dystrophy (DM), seven facioscapurohumeral muscular dystrophy (FSHD), two limb-girdle muscular dystrophy and six healthy volunteers, were enrolled in this study and 27 participants completed it. All participants took creatine 20g/day for an initial week and 5g/day for successive eight weeks. Somatotonic measurements, global subjective assessment, muscle performance, cardiopulmonary function, cognitive function, laboratory studies and magnetic resonance spectroscopy (MRS) were evaluated at both pre and post examination. Subjective improvements were reported from twelve individuals. Contrary adverse effects were also complained from ten individuals, although all these problems were not serious. Quantitative muscle power was slightly but significantly increased in the patients and the number of the patients who failed to complete cycle ergometer test was decreased. Phosphocreatine concentrations of left calf muscle were not different between pre and post trial examination. No obvious changes were detected in cardiopulmonary assessment, cognitive function and laboratory date. Creatine has certain expectance for muscular dystrophy patients in motor performance. The effect may be achieved not only by increase of energy buffer, because clinical improvements were observed in our study nevertheless no increase was detected in phosphocreatine concentration. The usage of creatine should be managed under medical monitoring since ideal protocol has not yet been established and adverse effects can not be ignored.

摘要

为研究一水肌酸对肌营养不良患者肌肉性能和认知功能的影响,我们进行了一项开放性试验。本研究纳入了29名个体,包括14名强直性肌营养不良(DM)患者、7名面肩肱型肌营养不良(FSHD)患者、2名肢带型肌营养不良患者以及6名健康志愿者,其中27名参与者完成了试验。所有参与者在最初一周每天服用20克肌酸,随后八周每天服用5克肌酸。在检查前后均对躯体张力测量、整体主观评估、肌肉性能、心肺功能、认知功能、实验室检查以及磁共振波谱(MRS)进行了评估。12名个体报告有主观改善。10名个体也抱怨有相反的不良反应,不过所有这些问题都不严重。患者的定量肌肉力量略有但显著增加,未能完成蹬车测力计测试的患者数量减少。试验前后左小腿肌肉的磷酸肌酸浓度无差异。心肺评估、认知功能和实验室数据未检测到明显变化。肌酸对肌营养不良患者的运动表现有一定期望。这种效果可能不仅通过增加能量缓冲来实现,因为在我们的研究中尽管未检测到磷酸肌酸浓度增加,但仍观察到了临床改善。由于尚未建立理想的方案且不良反应不可忽视,肌酸的使用应在医学监测下进行。

相似文献

1
[A clinical trial of creatine monohydrate in muscular dystrophy patients].[肌酸单水合物在肌营养不良患者中的临床试验]
Rinsho Shinkeigaku. 2004 Oct;44(10):661-6.
2
Creatine monohydrate supplementation does not increase muscle strength, lean body mass, or muscle phosphocreatine in patients with myotonic dystrophy type 1.补充一水肌酸不会增加1型强直性肌营养不良患者的肌肉力量、去脂体重或肌肉磷酸肌酸。
Muscle Nerve. 2004 Jan;29(1):51-8. doi: 10.1002/mus.10527.
3
Creatine monohydrate in myotonic dystrophy: a double-blind, placebo-controlled clinical study.肌强直性营养不良中一水肌酸的双盲、安慰剂对照临床研究。
J Neurol. 2002 Dec;249(12):1717-22. doi: 10.1007/s00415-002-0923-x.
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Measurement of the functional status of patients with different types of muscular dystrophy.不同类型肌营养不良患者功能状态的测量。
Kaohsiung J Med Sci. 2009 Jun;25(6):325-33. doi: 10.1016/S1607-551X(09)70523-6.
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Expression profile of FSHD supports a link between retinal vasculopathy and muscular dystrophy.面肩肱型肌营养不良症的表达谱支持视网膜血管病变与肌肉营养不良之间的联系。
Neurology. 2007 Feb 20;68(8):569-77. doi: 10.1212/01.wnl.0000251269.31442.d9. Epub 2006 Dec 6.
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Shank sign in myotonic dystrophy type-1 (DM-1).
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Creatine monohydrate in muscular dystrophies: A double-blind, placebo-controlled clinical study.肌营养不良症中一水肌酸的双盲、安慰剂对照临床研究。
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Psychiatric disorders appear equally in patients with myotonic dystrophy, facioscapulohumeral dystrophy, and hereditary motor and sensory neuropathy type I.强直性肌营养不良、面肩肱型肌营养不良和I型遗传性运动感觉神经病患者出现精神障碍的几率相同。
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[Therapeutic trial with allopurinol in progressive muscular dystrophy (author's transl)].
An Esp Pediatr. 1982 Jan;16(1):42-6.

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