Matsumura Tsuyoshi, Yokoe Masaru, Nakamori Masayuki, Hattori Noriaki, Saito Toshio, Nozaki Sonoko, Fujimura Harutoshi, Shinno Susumu
Department of Neurology, National Hospital Organization Toneyama National Hospital.
Rinsho Shinkeigaku. 2004 Oct;44(10):661-6.
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.
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。