司来吉兰的临床研究进展及安全性.PDFVIP

中国临床神经科学 2012年第20卷第4期 424 Chin J Clin Neurosci 2012,20 (4),424~433 疾病的新认识和新治疗 司来吉兰的临床研究进展及安全性 1 2 蒋雨平 ，蒋雯巍 1 2 (复旦大学附属华山医院 神经科；老年科200040) 关键词 司来吉兰；帕金森病；单胺氧化酶-B抑制剂；安全性；奶酪反应；5-羟色胺综合征 摘要 通过文献回顾，详细描述单胺氧化酶-B 抑制剂司来吉兰的研究历史、化学结构、药动学及临床研究的进展，并 从多方面阐述其安全性。司来吉兰10 mg ·d-1 单药治疗能改善早期帕金森病(PD)患者的运动徐缓/ 少动症状，延迟左旋 多巴的应用，延迟疾病的进展。司来吉兰与左旋多巴合用可改善晚期PD 患者症状，减少左旋多巴服药次数和剂量，改 善和减少与左旋多巴剂量相关的症状波动。除PD 外，研究发现司来吉兰能有效治疗儿童和成人的注意力缺陷多动症； 改善阿尔茨海默病和额颞痴呆患者的认知功能和日常生活能力；减少发作性睡病的突发睡眠次数；减少睡眠中周期性 肢体运动的肌阵挛发作次数；有效治疗PD 伴发抑郁，且对戒烟有帮助。司来吉兰的治疗剂量安全性佳。 1 2 The Development of Clinical Trial and Safety of Selegiline JIAN G Yu-Ping , JIAN G Wen- Wei 1 2 Department of Neurology, Department of Geriatrics, Huashan Hospital, Fudan University, Shanghai 200040, China KEY WORDS selegiline; Parkinson’s disease; MAO-B inhibitor; safety; cheese reaction; serotonin syndrome ABSTRACT This is a review of literature on the selegiline used in Parkinson ’s disease(PD). By the early 1960s, Knoll and colleagues developed a methamphetamine derivative (E-250), later named deprenyl that was developed L-deprenyl, now referred to as selegiline. The pharmacokinetic properties of selegiline, the chemical structure and the safety were reviewed. The use of selegiline 10 mg·d-1 of monotherapy in early PD was demonstrated a symptomatic benefit, a reduction in disability, a delay in the use of L-dopa therapy and a delay on disease progression. Selegiline is used in combination with L -dopa in more advanced disease and may suggest that reduced the end-of-dose motor fl