Crapper McLachlan D R, Dalton A J, Kruck T P, Bell M Y, Smith W L, Kalow W, Andrews D F
Department of Physiology, University of Toronto, Ontario, Canada.
Lancet. 1991 Jun 1;337(8753):1304-8. doi: 10.1016/0140-6736(91)92978-b.
Although epidemiological and biochemical evidence suggests that aluminium may be associated with Alzheimer's disease (AD), there is no convincing proof of a causal link for aluminium in disease progression. We have completed a two year, single-blind study to investigate whether the progression of dementia could be slowed by the trivalent ion chelator, desferrioxamine. 48 patients with probable AD were randomly assigned to receive desferrioxamine (125 mg intramuscularly twice daily, 5 days per week, for 24 months), oral placebo (lecithin), or no treatment. No significant differences in baseline measures of intelligence, memory, or speech ability existed between groups. Activities of daily living were assessed and videorecorded at 6, 12, 18, and 24 month intervals. There were no differences in the rate of deterioration of patients receiving either placebo or no treatment. Desferrioxamine treatment led to significant reduction in the rate of decline of daily living skills as assessed by both group means (p = 0.03) and variances (p less than 0.04). The mean rate of decline was twice as rapid for the no-treatment group. Appetite (n = 4) and weight (n = 1) loss were the only reported side-effects. We conclude that sustained administration of desferrioxamine may slow the clinical progression of the dementia associated with AD.
尽管流行病学和生物化学证据表明铝可能与阿尔茨海默病（AD）有关，但尚无确凿证据证明铝在疾病进展中存在因果联系。我们完成了一项为期两年的单盲研究，以调查三价离子螯合剂去铁胺是否可以减缓痴呆症的进展。48名可能患有AD的患者被随机分配接受去铁胺（每日两次，每次125mg肌肉注射，每周5天，共24个月）、口服安慰剂（卵磷脂）或不接受治疗。各组之间在智力、记忆或语言能力的基线测量上没有显著差异。在6、12、18和24个月的间隔时间对日常生活活动进行评估并录像。接受安慰剂或不接受治疗的患者的恶化速度没有差异。通过组均值（p = 0.03）和方差（p小于0.04）评估，去铁胺治疗导致日常生活技能下降率显著降低。未治疗组的平均下降速度快两倍。食欲减退（n = 4）和体重减轻（n = 1）是唯一报告的副作用。我们得出结论，持续给予去铁胺可能会减缓与AD相关的痴呆症的临床进展。
