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一项针对50名相对能力较强的自闭症儿童,使用促肾上腺皮质激素(4-9)类似物ORG 2766进行的对照试验。

A controlled trial with ORG 2766, an ACTH-(4-9) analog, in 50 relatively able children with autism.

作者信息

Buitelaar J K, Dekker M E, van Ree J M, van Engeland H

机构信息

Department of Child and Adolescent Psychiatry, University of Utrecht, Netherlands.

出版信息

Eur Neuropsychopharmacol. 1996 Mar;6(1):13-9. doi: 10.1016/0924-977x(95)00049-u.

Abstract

The aim of the present study was to replicate earlier findings of beneficial effects of ORG 2766, an ACTH-(4-9) analog, in autistic children. Fifty children with autism, 7-15 years old and with a Performance IQ of more than 60, participated in a double-blind placebo controlled parallel trial. Active treatment was 40 mg ORG 2766 for 6 weeks. The outcome was assessed on the basis of the Aberrant Behavior Checklist completed by parents and teachers, and by means of a detailed behavioral observation (30 subjects). ORG 2766 failed to improve social and communicative behavior at a group level. The rate of individual response, defined as a reliable change in social withdrawal at home and at school, to ORG 2766 (10 out of 30) and placebo (4 out of 20) was not significant either. The children who responded to ORG 2766, but not those who responded to placebo, manifested significant improvements outside the changes in the defining variables, including a decrease in hyperactivity at school. The responders to ORG 2766 were characterized mainly by a relatively lower PIQ; further by more initial hyperactivity, stereotypies and abnormal speech, and less initial eye contact. The responders to placebo could not be differentiated from the non-responders to placebo. Future studies should examine whether ORG 2766 differentially affects various subtypes of autism.

摘要

本研究的目的是重复早期关于促肾上腺皮质激素(4-9)类似物ORG 2766对自闭症儿童有益作用的研究结果。五十名7至15岁、操作智商高于60的自闭症儿童参与了一项双盲安慰剂对照平行试验。积极治疗为使用40毫克ORG 2766,为期6周。根据家长和教师填写的异常行为清单以及详细的行为观察(30名受试者)对结果进行评估。ORG 2766在群体水平上未能改善社交和沟通行为。对ORG 2766(30名中有10名)和安慰剂(20名中有4名)的个体反应率,即在家中和学校社交退缩方面的可靠变化,也不显著。对ORG 2766有反应的儿童,而非对安慰剂有反应的儿童,在定义变量变化之外表现出显著改善,包括学校里多动行为的减少。对ORG 2766有反应的儿童主要特征为相对较低的操作智商;进一步表现为更多的初始多动、刻板行为和言语异常,以及更少的初始眼神接触。对安慰剂有反应的儿童与对安慰剂无反应的儿童无法区分。未来的研究应考察ORG 2766是否对自闭症的各种亚型有不同影响。

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