老药新用：米诺环素减轻中风损害

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老药新用：米诺环素减轻中风损害

发表在Neurology上的一项研究称，患者在中风发作一天内服用米诺环素，长期身心障碍的风险较未接受此药物治疗的同类患者低。
这项中风治疗研究纳入了150例因入院时间过晚而不能进行凝块击碎治疗的患者，排除已经出现恢复迹象的患者。患者及其医生知道谁在服用米诺环素，谁在服用安慰剂，但评估患者病情的神经病学家并不知情。根据NIH卒中量表，对患者进行了评价。三个月后，接受了米诺环素的患者平均评分为1.6 ，提示很少或没有残疾。服用安慰剂的患者平均评分为6.5 ，表明轻度残疾。
因本研究规模相当小，故需要更大群体的患者来重复这一结果。但这一发现令人鼓舞，部分原因是医生们对很多刚刚发生中风的患者束手无策。Genentech的药物tPA可以击碎造成中风的血块，但只有在症状出现后立即给药才有效，这使得治疗非常困难。
NIH解释，米诺环素可减轻炎症，并可能防止与中风及其它神经系统疾病有关的脑细胞死亡。研究人员也正在测试米诺环素对肌肉萎缩症及亨廷顿舞蹈病患者的效果。
米诺环素十多年前由Lederle实验室发现，以商品名Minocin上市。它是一种非专利抗生素，通常用于治疗痤疮。


译文来自丁香园
http://www.dxy.cn/bbs/post/view? ... amp;tpg=1&age=0

October 2, 2007, 9:04 am
An Old Antibiotic Could Reduce Stroke Damage
Posted by Jacob Goldstein

A generic antibiotic often used to treat acne may find a new life as a treatment for strokes.

Patients who received the drug, minocycline, within a day of having a stroke had less risk of long-term mental and physical impairments than similar patients who didn’t receive the drug, says a study published in Neurology. Minocyline was discovered decades ago by Lederle Laboratories, now part of Wyeth, and is marketed under the brand-name Minocin.

The provocative study in stroke treatment was pretty small — 150 patients total — and will need to be repeated in a larger group of patients before doctors accept the findings, the Los Angeles Times notes.

But the findings are promising, partly because there’s not much doctors can do for many patients who’ve just had a stroke. Genentech’s drug tPA is approved to bust clots causing stroke, but only when given almost immediately after the onset of symptoms — a window that makes treatment tough.

As this NIH page explains, minocycline tends to reduce inflammation, and may prevent the death of brain cells associated with stroke and other neurological problems. It’s also being tested in patients with Lou Gehrig’s disease and Huntington’s disease.

The study enrolled patients who arrived at the hospital too late for clot-busting therapy, and excluded those who were already showing signs of recovery. Patients and their doctors knew who was getting minocylcine and who was getting placebo, but the neurologists who evaluated the patients in the following weeks did not.

The patients were evaluated based on the NIH stroke scale. After three months, those who received minocycline had an average score 1.6, which indicates little or no disability. Patients who got placebo had an average score of 6.5, which indicates mild disability