应用头颅多层面螺旋CT定量评估多奈哌齐治疗阿尔茨海默病的效应  

Effects of aricept on the treatment of Alzheimer disease evaluated by skull multi-slice helical CT

作　　者：张毅[1] 杨蓉佳[1] 郭菊英[1] 黄刚[1] 王超美[1] 

机构地区：[1]甘肃省人民医院神经内科,甘肃省兰州市730000

出　　处：《中国临床康复》2005年第25期20-21,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨可逆性乙酰胆碱脂酶抑制剂多奈哌齐对阿尔茨海默病患者智能和日常生活活动能力的改善作用,并观察头颅多层面螺旋CT和脑电图结果与临床症状的符合情况。方法:选择2001-07/2003-08甘肃省人民医院住院的阿尔茨海默病患者120例,随机分为多奈哌齐组和对照组各60例,两组基础治疗相同,多奈哌齐组加用多奈哌齐5mg/d治疗,两组均连续治疗60d。治疗前后应用头颅多层面螺旋CT评估脑皮质萎缩情况(正常人脑沟测量值≥42mm);应用脑电图评估神经细胞功能的改变以及代谢衰退情况;应用日常生活活动能力量表评估日常生活活动能力;应用简明精神状态检查表评估智能状态。结果:按实际处理分析,111例患者进入结果分析。①日常生活活动能力量表评分结果:治疗前两组无差异,治疗后多奈哌齐组明显低于对照组(30.52±1.38,31.76±1.75,P<0.05)。②简明精神状态检查表评分结果:治疗前两组无差异,治疗后多奈哌齐组总分明显高于对照组(23.87±1.62,21.98±1.75,t=2.96,P<0.05),且在记忆力,定向力,计算力和语言能力方面均优于对照组。③脑沟测量值:治疗前两组无差异,治疗后多奈哌齐组在数值上高于对照组,但差异无统计学意义犤(38.49±1.06),(38.16±0.55)mm,P>0.05犦。④脑电图结果:治疗后多奈哌齐组平均有效率高于对照组犤(59.89±16.98)%,(27.78±4.02)%,t=4.50,P<0.01犦。结论:①阿尔茨海默病患者均表现为皮质萎缩,以经头颅多层面螺旋CT脑沟测量值<42mm定量反映阿尔茨海默病的病理基础和程度,与临床症状相符合。②多奈哌齐可改善患者的智能和日常生活活动能力,但治疗后多层面螺旋CT检测脑沟测量值变化不明显,可能是2个月的治疗时间为期太短,尚未发生形态学的改变。AIM： To explore the amelioration action of aricept of reciprocity acetylcholine lipase inhibitor on intelligence and activities of daily living （ADL） in patients with Alzheimer disease （AD）, and observe the coincidence condition of skull multi-slice helical CT and the results of electroencephalogram （EEG） with clinical symptom. METHODS： 120 inpatients with AD were selected from Gansu People＇s Hospital from July 2001 to August 2003. They were divided randomly into aricept group and control group with 60 patients in each group. The same treatment were used in the two groups. In addition, patients in aricept group were taken 5 mg aricept per day. Patients in the two groups were all treated for 60 days. Atrophy condition of brain cortex was evaluated by MSCT before and after treatment （Measured value of normal human suleus was over or equal to 42 mm）. Changes and metabolism diminution condition of nerve cell function were evaluated by EEG. ADL was evaluated by ADL ability measurement. Intellectual status was evaluated by mini-mental state examination（MMSE）. RESULTS： According to practical disposal analysis, 111 patients were involved in the analysis of results. ① Scores of ability of ADL： There were not differences between the two groups beforetreatment. Scores in aricept group were significantly lower than those of control group after treatment （30.52±1.38, 31.76±1.75, P 〈 0.05 ）. ② Scores of concise mental status inspection measurement： There were no differences between the two groups before treatment. After treatment the total scores in arieept group were significantly higher than those of control group （23.87±1.62, 21.98±1.75, t=2.96, P 〈 0.05）,and scores of anamnesis, orientation, ability of calculation and language ability were higher than those of control group. ③ Measured value of suleus： There were no differences between the two groups before treatment. After treatment the scores in arieept group were higher than that of control group, but the differenc

关 键 词：阿尔茨海默病/放射摄影术 胆碱脂酶抑制剂 日常生活活动 脑电描记术 体层摄影术 X线计算机 

分 类 号：R749[医药卫生—神经病学与精神病学]