Wilson M M G, Philpot C, Morley J E
Division of Geriatric Medicine, Saint Louis University, 1402, S. Grand Blvd, Rm M238, St Louis, MO 63104, USA.
J Nutr Health Aging. 2007 Mar-Apr;11(2):195-8.
Anorexia and subsequent weight loss increase the risk of death in long term care (LTC) residents. In patients who fail to respond to nutritional intervention, orexigenic drugs are sometimes prescribed. There is limited data regarding the safety and efficacy of these drugs in older adults.
To examine the effect of a 12-week course of dronabinol on LTC residents with anorexia and significant weight loss.
DESIGN, SETTING, PARTICIPANTS: Retrospective observational study on residents in five LTC facilities in a major metropolitan area.
Twenty-eight subjects (22F, 6M) were involved in the study. Mean age 79.5 +/- 19.8 years (range 46-98 y). Mean body weight, serum albumin and serum prealbumin at baseline were 105.7 +/- 24.7 lbs, 3.39 +/- 0.47 g/dl and 22.15 +/- 7.92 mg/dl respectively. 15 subjects (53.5%) gained weight on dronabinol, of which 10 (67%) gained more than 5 lbs and 6(40%) gained more than 10 lbs. Five (33%) subjects gained less than 5 lbs. Residents who lost weight on dronabinol were younger than those who gained weight (70.9 +/- 5.62 y and 90.8 +/- 7.84 y respectively; p = 0.007) Overall, the mean weight gain on dronabinol was 3 +/- 8.01 lbs (p=0.2). Eleven subjects lost weight (mean loss 3 +/- 2.6 lbs). Of the subjects who lost weight 7 (64%) died compared with 4 (26%) in the subgroup who gained weight.
Dronabinol therapy was well tolerated. Overall, there was a trend toward weight gain in LTC residents treated with 12 weeks of dronabinol. Failure to respond to dronabinol may indicate increased risk of death.
厌食及随后的体重减轻会增加长期护理（LTC）机构居民的死亡风险。对于营养干预无反应的患者，有时会开具食欲增强药物。关于这些药物在老年人中的安全性和有效性的数据有限。
研究为期12周的屈大麻酚疗程对患有厌食症且体重显著减轻的LTC机构居民的影响。
设计、地点、参与者：对一个大城市地区五个LTC机构的居民进行回顾性观察研究。
28名受试者（22名女性，6名男性）参与了研究。平均年龄79.5±19.8岁（范围46 - 98岁）。基线时平均体重、血清白蛋白和血清前白蛋白分别为105.7±24.7磅、3.39±0.47克/分升和22.15±7.92毫克/分升。15名受试者（53.5%）服用屈大麻酚后体重增加，其中10名（67%）体重增加超过5磅，6名（40%）体重增加超过10磅。5名（33%）受试者体重增加少于5磅。服用屈大麻酚后体重减轻的居民比体重增加的居民年轻（分别为70.9±5.62岁和90.8±7.84岁；p = 0.007）。总体而言，服用屈大麻酚后的平均体重增加为3±8.01磅（p = 0.2）。11名受试者体重减轻（平均减轻3±2.6磅）。体重减轻的受试者中有7名（64%）死亡，而体重增加的亚组中有4名（26%）死亡。
屈大麻酚治疗耐受性良好。总体而言，接受12周屈大麻酚治疗的LTC机构居民有体重增加的趋势。对屈大麻酚无反应可能表明死亡风险增加。
