Gredal O, Werdelin L, Bak S, Christensen P B, Boysen G, Kristensen M O, Jespersen J H, Regeur L, Hinge H H, Jensen T S
Research Institute of Biological Psychiatry, St Hans Hospital, Roskilde, Denmark.
Acta Neurol Scand. 1997 Jul;96(1):8-13. doi: 10.1111/j.1600-0404.1997.tb00231.x.
Although the cause of amyotrophic lateral sclerosis (ALS) is unknown, excitotoxicity mediated by glutamate has been implicated. Dextromethorphan is a NMDA-glutamate receptor antagonist with neuroprotective properties.
The effect of treatment with dextromethorphan (150 mg daily) in ALS patients was evaluated in a randomized, double-blind, placebo-controlled study. Forty-five patients were included in the analysis.
At the end of the treatment period, 12 months after randomization, 15 patients (65%) in the placebo group and 12 patients (55 %) in the dextromethorphan group were still alive (log rank test, P=0.49). Rates of disease progression, as expressed by rates of decline in pulmonary function and in functional disability, were similar in both groups except for a significantly less pronounced rate of decline in the ability scores for the lower extremities in the dextromethorphan group.
Treatment with a relatively low dose of dextromethorphan did not result in an improvement in 12-month survival in ALS.
尽管肌萎缩侧索硬化症（ALS）的病因尚不清楚，但谷氨酸介导的兴奋性毒性已被牵连其中。右美沙芬是一种具有神经保护特性的NMDA-谷氨酸受体拮抗剂。
在一项随机、双盲、安慰剂对照研究中评估了右美沙芬（每日150毫克）对ALS患者的治疗效果。45名患者纳入分析。
在治疗期结束时，随机分组12个月后，安慰剂组有15名患者（65%）存活，右美沙芬组有12名患者（55%）存活（对数秩检验，P = 0.49）。两组的疾病进展率，以肺功能和功能残疾的下降率表示，相似，只是右美沙芬组下肢能力得分的下降率明显不那么显著。
使用相对低剂量的右美沙芬治疗并未使ALS患者的12个月生存率得到改善。
