速利清治療中樞神經疾患：缺血性腦中風及血管性失智症回顧

An Overview of the Role of Cerebrolysin in Central Nervous System Disorders: Stroke and Vascular Dementia

張谷州(Ku-Chou Chang) ； 孫瑜(Yu Sun) ； 陳信穎(Hsin-Ying Chen) ； 周中興(Chung-Hsing Chou) ； 連立明(Li-Ming Lien) ； 林浚仁(Chun-Jen Lin) ； 劉濟弘(Chi-Hung Liu) ； 巫錫霖(Shey-Lin Wu) ； 陳柏霖(Po-Lin Chen) ； 宋碧姍(Pi-Shan Sung) ； 陳俊鴻(Chun-Hung Chen) ； 李俊泰(Jiunn-Tay Lee)

《台灣中風醫誌》 4卷2期 (2022/06) Pp. 76-86

https://doi.org/10.6318/FJS.202206_4(2).0003

摘要

Cerebrolysin（速利清）含多種神經胜肽及胺基酸，作用與腦內神經營養因子類似。在台灣，Cerebrolysin登記的適應症為不能攝取適當食物患者「補助治療劑」。Cerebrolysin在治療缺血性腦中風及血管性失智症方面的研究已具規模。本回顧整理基礎與臨床研究結果，供缺血性腦中風及血管性失智症患者的治療參考。缺血性腦中風72小時內開始Cerebrolysin治療，每天一次靜脈滴注30-50 mL，持續10-21天，配合積極復健，90天National Institutes of Health Stroke Scale（NIHSS）改善（Mann-Whitney（MW）0.60），益一需治數（Number Need to Treat）7.7。中重度嚴重患者（NIHSS ＞ 12），90天modified Rankin scale（mRS）改善（MW 0.61）。獲得國際治療指引的肯定。至於血管性失智症患者，使用Cerebrolysin可有效改善認知功能，以間歇療程每天靜脈滴注10-60 ml持續數週的間歇治療方式，相關療效早於治療開始後4週內出現。基於具規模的基礎與臨床研究，在統合性分析及國際指引實證建議支持下，可考慮使用Cerebrolysin於缺血性腦中風及血管性失智症患者。

關鍵字

速利清 ； 腦中風 ； 腦梗塞 ； 血管性失智

並列摘要

Cerebrolysin consists of neuropeptides and free amino acids with neurotrophic activities. In Taiwan, Cerebrolysin is listed for use as a supplementary regimen for patients with insufficient nutrient intake. Animal models and clinical studies have provided efficacy and safety data supporting the use of Cerebrolysin in patients with stroke and vascular dementia. This article is a concise overview of evidence which might be of value for patients in Taiwan. For ischemic stroke patients, Cerebrolysin initiated within 72 hours intravenously by 30-50 mg daily, along with intensive rehabilitation program, offered better improvement assessed by National Institutes of Health Stroke Scale (NIHSS) at 90 days (Mann-Whitney (MW) 0.60) and modified Rankin scale (mRS) (MW 0.61). The number need to treat was 7.7. For moderate to severe ischemic stroke patients, NIHSS improvement was reported at 90 days (MW 0.60). The use of Cerebrolysin has been recommended by European guidelines. For vascular dementia patients, Cerebrolysin infusion was associated with improvements in cognitive function as early as 4 weeks after therapy. Based on updated preclinical and clinical evidence from meta-analyses and recommendations by certain guidelines, the use of Cerebrolysin might be considered in patients suffering from stroke and vascular dementia.

並列關鍵字

Cerebrolysin ； stroke ； ischemic stroke ； vascular dementia