Hughes Shari, Colantonio Angela, Santaguida P Lina, Paton Thomas
Sunnybrook & Women's College Health Sciences Centre, Toronto, ON, Canada.
Brain Inj. 2005 Dec 20;19(14):1197-206. doi: 10.1080/02699050500309296.
To evaluate the association between amantadine and recovery of consciousness from prolonged traumatic coma.
A retrospective cohort study.
Subjects included 123 adults with severe traumatic brain injury (TBI) admitted over a 10-year period who remained in coma despite becoming medically stable.
Cases received 100-200 mg of amantadine twice daily.
46.4% (13/28) of cases emerged from coma compared to 37.9% (36/95) of controls (p = 0.42). Somatosensory evoked potential (SSEP) was the only significant predictor of emergence from coma (p = 0.02), while SSEP, age and Glasgow Coma Score (GCS) significantly predicted time to emerge from coma (p < 0.05).
Although the study and its design do not support the view that amantadine has an effect on recovery of consciousness; it remains safe, inexpensive and has few side effects. The lack of treatment alternatives and anecdotal support for its use may warrant further study. Prospective controlled trials would yield more definitive results.
评估金刚烷胺与长期创伤性昏迷后意识恢复之间的关联。
一项回顾性队列研究。
研究对象包括123名在10年期间因严重创伤性脑损伤（TBI）入院的成年人，尽管其病情在医学上已稳定，但仍处于昏迷状态。
病例组每日两次接受100 - 200毫克金刚烷胺治疗。
46.4%（13/28）的病例组患者从昏迷中苏醒，而对照组这一比例为37.9%（36/95）（p = 0.42）。体感诱发电位（SSEP）是昏迷苏醒的唯一显著预测指标（p = 0.02），而SSEP、年龄和格拉斯哥昏迷评分（GCS）显著预测了昏迷苏醒时间（p < 0.05）。
尽管该研究及其设计并不支持金刚烷胺对意识恢复有影响这一观点；但它仍然安全、廉价且副作用少。由于缺乏其他治疗选择以及有轶事支持其使用，可能值得进一步研究。前瞻性对照试验将产生更明确的结果。
