百优解治疗小脑性共济失调与血小板5-HT测定

A preliminary study on efficacy of prozac and determination of platelet 5-HT in patients with cerebellar ataxia

目的 探讨百优解治疗小脑性共济失调的疗效和作用机制。方法 接受百优解治疗的患者 2 0例 ,治疗前后进行病情评分和血小板 5 -羟色胺 ( 5 - HT)测定 ,与毒扁豆碱治疗组 ( 2 6例 )、对照组 ( 112例健康查体者 )进行疗效对比。结果 ( 1)百优解治疗组的疗效 ( 70 .0 %)优于毒扁豆碱治疗组 ( 3 8.5 %) ( P<0 .0 5 ) ;( 2 )患者组血小板5 - HT水平低于对照组 ,具有极显著意义 ( P<0 .0 0 1) ;( 3 )百优解治疗前后血小板 5 - HT浓度改变 ,有效的 10例有下降趋势 ,无效的 5例明显增高。结论 ( 1)百优解对小脑性共济失调具有肯定的疗效 ,与 5 - HT代谢缺陷得到纠正有关 ;( 2 )血小板 5 - HT测定可能成为小脑性共济失调诊断和疗效评估的客观化验指标。

Objective To evaluate the efficacy and the role of Prozac in treating patients with mild cerebellar ataxia. Methods Twenty patients confirmed by clinical features and radiological images received oral Prozac for at least two months. Ataxia rating scale and platelet 5-HT assay were measured prior to and posterior to the study. The effect of this series was compared to another our own previous series which included twenty-six age-,sex- and state-marched patients by using oral Physostigmine. Results (1)The efficiency of Prozac-treated series was superior to that of Physostigmine-treated one (P<0.05);(2) The mean value of platelet 5-HT in the patient group was lower than that in the control group containing 112 healthy persons very significantly (P<0.001);(3) The changes of platelet 5-HT contents between the beginning and the end of therapy were quite different based upon the therapeutic effects. There was a tendency to decrease in ten responders after treatment,while in five no-responders the levels were elevated prominently. Conclusion (1)Prozac is definitely active in cerebellar ataxia. It is suggested that the pharmacological mechanism might be due to modification of serotonergic deficiency;(2)The determination of platelet 5-HT is likely to become an objective laboratorial index in cerebellar degeneration,either for the estimation of clinical diagnosis or for that of therapeutic efficacy.