口服DMSA治疗自闭症谱系障碍儿童的安全性和有效性:B部分-行为结果。

James B Adams, Matthew Baral, Elizabeth Geis, Jessica Mitchell, Julie Ingram, Andrea Hensley, Irene Zappia, Sanford Newmark, Eva Gehn, Robert A Rubin, Ken Mitchell, Jeff Bradstreet, Jane El-Dahr
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引用次数: 30

摘要

背景:本研究探讨口服二巯基琥珀酸(DMSA)对3-8岁自闭症谱系障碍(ASD)儿童行为症状的影响。方法:第一阶段纳入65例ASD患儿,接受一轮DMSA(3天)。尿中有毒金属排泄量高的参与者被选中继续进行第二阶段。在第二阶段,49名参与者被随机分配到双盲设计中,接受额外的6轮DMSA或安慰剂。结果:1轮和7轮DMSA治疗组在各项评价指标上均有显著改善。对于7轮组,基于有毒金属排泄和谷胱甘肽变化的回归分析可以部分解释评估指标的改善程度(调整R2为0.28-0.75,所有病例p < 0.02)。一剂DMSA的效果与七剂几乎相同。在研究开始时,各评价指标之间的相关性较好(r = 0.60-0.87),在研究结束时相关性更强(r = 0.63-0.94)。结论:总的来说,对于尿中有毒金属排泄量高的ASD儿童,1轮和7轮DMSA治疗似乎都是相当安全的,并且可能有助于减轻这些儿童的某些自闭症症状。
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Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: part B - behavioral results.

Background: This study investigated the effects of oral dimercapto succinic acid (DMSA) therapy on the behavioural symptoms of children with autism spectrum disorders (ASD) ages 3-8 years.

Methods: Phase 1 involved 65 children with ASD who received one round of DMSA (3 days). Participants who had high urinary excretion of toxic metals were selected to continue on to phase 2. In phase 2, 49 participants were randomly assigned in a double-blind design to receive an additional 6 rounds of either DMSA or placebo.

Results: The groups receiving one round and seven rounds of DMSA had significant improvements on all the assessment measures. For the seven round group, the degree of improvement on the assessment measures could be partially explained by a regression analysis based on excretion of toxic metals and changes in glutathione (adjusted R2 of 0.28-0.75, p < 0.02 in all cases). One round of DMSA had nearly the same benefit as seven rounds. The assessment measures correlated reasonably with one another at the beginning of the study (r = 0.60-0.87) and even better at the end of the study (r = 0.63-0.94).

Conclusion: Overall, both one and seven rounds of DMSA therapy seems to be reasonably safe in children with ASD who have high urinary excretion of toxic metals, and possibly helpful in reducing some of the symptoms of autism in those children.

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