Brannan T, Yahr M D
Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029.
Ann Neurol. 1995 Jan;37(1):95-8. doi: 10.1002/ana.410370117.
The long-term effect of selegiline (L-deprenyl) in the treatment of Parkinson's disease has not been clearly delineated. We report on a group of patients whose treatment was initiated with selegiline (n = 43) and then subsequently included L-dopa-carbidopa (Sinemet) and in whom an extended period of observation was carried out; they are compared to a group of patients whose treatment consisted of L-dopa-carbidopa alone (n = 39). In each, serial observations of the parkinsonian state and the response to treatment on a yearly basis for a period of 5 years were performed. No significant difference in the Hoehn-Yahr stage or in the motor subscores of tremor, rigidity, bradykinesia, and gait-posture was found between the two groups, nor was there a significant difference in the incidence of fluctuating responses or dyskinesias. The group that received combination therapy required less L-dopa than did the group that received L-dopa-carbidopa alone during the first 3 years of treatment and a similar trend was evident in years 4 to 5. We conclude that minimal benefits accrued to the parkinsonian patients from long-term use of selegiline. No clinical evidence to support the claim of "neuroprotective" properties was found. Selegiline's major usefulness is to modify the fluctuating therapeutic response seen with L-dopa-carbidopa.
司来吉兰（L-司来吉兰）治疗帕金森病的长期效果尚未明确界定。我们报告一组患者，他们最初接受司来吉兰治疗（n = 43），随后使用左旋多巴-卡比多巴（息宁），并进行了长期观察；将他们与另一组仅接受左旋多巴-卡比多巴治疗的患者（n = 39）进行比较。对每组患者在5年期间每年进行帕金森病状态及治疗反应的系列观察。两组之间在霍恩-亚尔分级或震颤、强直、运动迟缓及步态姿势的运动子评分方面均未发现显著差异，在反应波动或异动症的发生率方面也无显著差异。在治疗的前3年，接受联合治疗的组比仅接受左旋多巴-卡比多巴治疗的组需要的左旋多巴更少，在第4至5年也有类似趋势。我们得出结论，帕金森病患者长期使用司来吉兰获益极小。未发现支持其具有“神经保护”特性这一说法的临床证据。司来吉兰的主要作用是改善左旋多巴-卡比多巴治疗中出现的反应波动。
