Leibovitz Arthur, Lidar Merav, Baumoehl Yehuda, Livneh Avi, Segal Refael
Shmuel Harofeh Hospital, Geriatric Medical Center, Beer Yaakov, Israel.
Isr Med Assoc J. 2006 Jul;8(7):469-72.
[corrected] Colchicine is widely used for treating gout and familial Mediterranean fever. However, studies in animal models have reported ill effects of colchicine on the central nervous system, including cognitive function.
To evaluate the cognitive status of elderly FMF patients on long-term colchicine treatment.
The study group consisted of 55 FMF patients aged 74 +/- 5, attending an FMF outpatient clinic and receiving colchicine treatment for 25.1 +/- 8.9 years. The Mini-Mental State Examination was used for cognitive evaluation. Patients' scores were compared with accepted age- and education-adjusted cutoff scores, population-based norms, and scores of a matched control group of 56 subjects.
Individually, all colchicine-treated FMF patients scored well above the age- and education-corrected cutoff scores. Overall, there was a large difference, 5.0 +/- 1.6, from the expected cutoff points, in favor of the study group scores (P < 0.001). The individual scores of the control group were also above the cutoff points, however with a lower but still statistically significant difference (3.71 +/- 1.15 points, P < 0.001). Compared to population-based norms adjusted by age and education, the study group had significantly higher mean MMSE scores (27.2 +/- 2.2 vs. 25.5 +/- 2.4, P < 0.001). The control group's scores were also somewhat higher than expected, but not significantly so.
Our results do not support the view that prolonged colchicine treatment may be associated with cognitive impairment. On the contrary, it is possible that long-term colchicine treatment may even confer protection against cognitive decline in patients with FMF.
[已修正]秋水仙碱广泛用于治疗痛风和家族性地中海热。然而，动物模型研究报告了秋水仙碱对中枢神经系统的不良影响，包括认知功能。
评估长期接受秋水仙碱治疗的老年家族性地中海热（FMF）患者的认知状态。
研究组由55名年龄为74±5岁的FMF患者组成，他们在FMF门诊就诊，接受秋水仙碱治疗25.1±8.9年。使用简易精神状态检查表进行认知评估。将患者的得分与公认的年龄和教育程度校正后的临界分数、基于人群的常模以及56名受试者的匹配对照组的得分进行比较。
单独来看，所有接受秋水仙碱治疗的FMF患者得分均远高于年龄和教育程度校正后的临界分数。总体而言，与预期临界分数相比存在较大差异，为5.0±1.6，有利于研究组得分（P<0.001）。对照组的个体得分也高于临界分数，然而差异较小但仍具有统计学意义（3.71±1.15分，P<0.001）。与按年龄和教育程度调整的基于人群的常模相比，研究组的简易精神状态检查表（MMSE）平均得分显著更高（27.2±2.2对25.5±2.4，P<0.001）。对照组的得分也略高于预期，但不显著。
我们的结果不支持长期秋水仙碱治疗可能与认知障碍有关的观点。相反，长期秋水仙碱治疗甚至可能对FMF患者的认知衰退起到保护作用。
