Harbaugh R E, Reeder T M, Senter H J, Knopman D S, Baskin D S, Pirozzolo F, Chui H C, Shetter A G, Bakay R A, Leblanc R
Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire.
J Neurosurg. 1989 Oct;71(4):481-6. doi: 10.3171/jns.1989.71.4.0481.
The use of intracerebroventricular bethanechol chloride infusion in patients with Alzheimer's disease was first reported in 1984. An initial trial in four patients demonstrated the feasibility of this approach for cholinergic drug delivery to the brain, but objective improvement in cognitive function was not documented. A collaborative placebo-controlled double-blind crossover study has now been carried out in 49 patients with biopsy-documented Alzheimer's disease. The results demonstrate a statistical improvement in Mini-Mental State scores and significantly slower performance on Trails A testing during drug infusion. Other neuropsychological test scores were not similarly affected. The degree of improvement was not sufficient to justify further treatment of Alzheimer's disease patients by intracerebroventricular infusion of bethanechol chloride. The drug delivery system used in the study was well tolerated, with two irreversible complications in more than 50,000 patient days.
1984年首次报道了在阿尔茨海默病患者中使用脑室内注射氯化氨甲酰甲胆碱。最初对4名患者进行的试验证明了这种向大脑输送胆碱能药物方法的可行性，但未记录到认知功能的客观改善。现在对49例经活检证实为阿尔茨海默病的患者进行了一项安慰剂对照双盲交叉协作研究。结果显示，简易精神状态评分有统计学意义的改善，且在药物输注期间，A线试验的表现明显变慢。其他神经心理学测试分数未受到类似影响。改善程度不足以证明通过脑室内注射氯化氨甲酰甲胆碱对阿尔茨海默病患者进行进一步治疗是合理的。该研究中使用的药物输送系统耐受性良好，在超过50000个患者日中出现了两例不可逆并发症。
