Schneider L S, Farlow M
Department of Psychiatry, School of Medicine, Los Angeles, California, USA.
Ann N Y Acad Sci. 1997 Sep 26;826:317-22. doi: 10.1111/j.1749-6632.1997.tb48482.x.
In light of evidence that estrogen replacement might affect cholinergic function, we examined possible effects of estrogen replacement therapy (ERT) on clinical response to the cholinesterase inhibitor tacrine in women with Alzheimer's disease (AD). In a previously reported 30-week, randomized, double-blind, placebo-controlled, multicenter clinical trial, 14.5% of 318 women with evaluable data had been receiving ERT before randomization. They were randomly assigned to receive placebo or tacrine. Women receiving ERT who were randomized to tacrine improved more than women not receiving ERT who were randomized either to tacrine or to placebo as assessed by cognitive (p < 0.01) and clinical global (p = 0.02) tests. These results provide evidence that prior and continuing ERT may enhance response to tacrine in women with AD. Furthermore, among women on ERT receiving tacrine, there tended to be greater improvement relative to placebo among those without an APOE-epsilon 4 allele. Randomized trials are needed.
鉴于有证据表明雌激素替代可能会影响胆碱能功能，我们研究了雌激素替代疗法（ERT）对患有阿尔茨海默病（AD）的女性使用胆碱酯酶抑制剂他克林的临床反应的可能影响。在之前报道的一项为期30周的随机、双盲、安慰剂对照、多中心临床试验中，318名有可评估数据的女性中有14.5%在随机分组前接受过ERT。她们被随机分配接受安慰剂或他克林。通过认知测试（p < 0.01）和临床整体测试（p = 0.02）评估，随机接受他克林治疗的接受ERT的女性比随机接受他克林或安慰剂治疗的未接受ERT的女性改善更大。这些结果提供了证据，表明先前和持续的ERT可能会增强AD女性对他克林的反应。此外，在接受他克林治疗的ERT女性中，没有APOE-ε4等位基因的女性相对于安慰剂往往有更大的改善。需要进行随机试验。
