奥氮平与喹硫平对阿尔茨海默病伴发精神行为异常患者血同型半胱氨酸的影响  

Comparative study for effects of olanzapine and quetiapine on blood homocysteine in patients with BPSD of Alzheiner’s dimentia

作　　者：张永珍[1] 张俊英 方红丽[2] 马中子 汪四美[1] 孙剑 徐乐平 ZHANG Yongzhen;ZHANG Junying;FANG Hongli(Changzhou De’an hospital,Changzhou 213000,China)

机构地区：[1]江苏省常州市德安医院,江苏常州213000 [2]常州市第四人民医院科教科 [3]上海市徐汇区精神卫生中心 [4]解放军第904医院,常州

出　　处：《中国健康心理学杂志》2020年第3期325-328,共4页China Journal of Health Psychology

摘　　要：目的:探讨奥氮平与喹硫平对阿尔茨海默病伴发精神行为异常患者血同型半胱氨酸的影响。方法:将61例阿尔茨海默病伴发精神行为异常患者入院后即随机分为两组(奥氮平组30例,喹硫平组31例)。两组患者入院后均给予多奈哌齐作为促认知药,对于控制精神行为异常,奥氮平组给予奥氮平,喹硫平组为喹硫平干预。在治疗前及治疗6周末,所有入组患者分别予中文版简易智能精神状态检查量表(MMSE)、AD病理行为量表(BEHAVE-AD)测定,入组第2日及治疗6周末抽取空腹静脉血行血同型半胱氨酸(Homocysteine,Hcy)测定。结果:治疗6周末,两组患者MMSE评分治疗前后均无明显差异(P>0.05);两组BEHAVE-AD测评均较治疗前下降,两组患者之间在治疗后BEHAVE-AD测评无显著性差异(P>0.05);两组患者Hcy浓度均较治疗前升高,其中,奥氮平组较喹硫平组Hcy水平增幅大(t=2.113,P<0.05),差异有统计学意义。结论:奥氮平及喹硫平均可升高阿尔茨海默病患者的血Hcy浓度,且奥氮平较喹硫平升高幅度大。Objective:To investigate the effects of olanzapine and quetiapine on blood homocysteine in patients with behavioral and psychological symptoms of Alzheimer’s dementia.Methods:Sixty-one patients with behavioral and psychological symptoms of Alzheimer’s disease were randomly divided into two groups,30 patients in the olanzapine group and 31 patients in the quetiapine group.Both groups received donepezil as a pro-cognitive drug after admission.For the control of mental behavior abnormalities,olanzapine group was given olanzapine and quetiapine group was treated with quetiapine.Before the treatment and at the end of the 6 th week of treatment,all the patients were enrolled in the Chinese version of the Simple Intelligence Mental Status Examination Scale(MMSE)and the AD Pathological Behavior Scale(BEHAVE-AD).At the second day of the enrollment and the 6 th week of treatment,fasting venous blood was drawn and measured by homocysteine.Results:At the end of the 6 th week,there was no significant difference in the MMSE score between the two groups before and after treatment.The BEHAVE-AD scores of the two groups were lower than those before treatment(P<0.05),but there was no significant difference in BEHAVE-AD between the two groups after treatment.The concentration of Hcy in both groups was higher than that before treatment.The level of Hcy in the olanzapine group was significantly higher than that in the quetiapine group(t=2.113,P<0.05).Conclusion:Olanzapine and quetiapine can increase the blood Hcy of patients with Alzheimer’s disease,and olanzapine increases more than quintiapine.

关 键 词：奥氮平 喹硫平 阿尔茨海默病 血同型半胱氨酸 痴呆 心理症状 

分 类 号：R749[医药卫生—神经病学与精神病学]