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Neurology:咖啡因能否改善帕金森病患者的运动表现?

2017-11-28 易湛苗 环球医学

据了解,咖啡不止是种提神饮料,经常饮用还能减低罹患一些疾病的可能性。2017年10月,发表在《Neurology》上的一项多中心平行对照试验研究,评估了咖啡因对帕金森病(PD)患者运动表现的改善情况。

据了解,咖啡不止是种提神饮料,经常饮用还能减低罹患一些疾病的可能性。2017年10月,发表在《Neurology》上的一项多中心平行对照试验研究,评估了咖啡因对帕金森病(PD)患者运动表现的改善情况。

方法:在这项多中心平行对照试验中,具有1~8年病程、Hoehn & Yahr分期为1~3期、接受稳定对症治疗的PD患者随机分配到200mg咖啡因BID和相匹配的安慰剂胶囊治疗6~18个月的组中。首要研究问题为6个月时客观运动评分是否不同(运动障碍学会——统一帕金森病评定量表(MDS-UPDRS)-III,I级证据)。次要结局指标包括安全性和耐受性、运动症状(MDS-UPDRS-II)、运动波动、睡眠,非运动症状(MDS-UPDRS-I)、认知(蒙特利尔认知评估量表)和生活质量。

结果:60例患者接受了咖啡因,61例接受了安慰剂。咖啡因的耐受性良好,不良反应的发生率与安慰剂相似。与安慰剂相比,咖啡因治疗的帕金森运动症状(首要结局)无改善(MDS-UPDRS-III评分的组间差异,-0.48(95% CI,-3.21~2.25)分)。相似的,对于次要结局指标,任何时间点的运动体征或运动症状(MDS-UPDRS-II)无改变,生活质量无差异。第一个6个月的嗜睡有轻微的改善,但随着时间衰减。咖啡因治疗的运动障碍有轻微增加(MDS-UPDRS-4.1+4.2高0.25分),咖啡因与较差的认知功能测试评分有相关性(平均蒙特利尔认知评估量表评分比安慰剂差0.66(0.01~1.32))。

结论:咖啡因并未提供PD运动表现的临床重要改善(I级证据)。咖啡因与较低PD风险之间的流行病学关联似乎没有被症状的效果所解释。

证据分类:本研究提供了I级证据表明,PD患者使用咖啡因并未显着改善运动表现

原始出处:
Postuma R, Anang J, Pelletier A, et al.Caffeine as symptomatic treatment for Parkinson disease (Café-PD): A randomized trial.Neurology. 2017 Oct 24;89(17):1795-1803. doi: 10.1212/WNL.0000000000004568. Epub 2017 Sep 27.

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    2017-11-28 惠映实验室

    学习了.谢谢.

    0

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