齐拉西酮与奥氮平治疗痴呆精神行为症状的对照研究  

A comparative study of Ziprasidone and Olanzapine in the treatment of behavioral and psychological symptoms of dementia

作　　者：徐萍[1] 李晨虎[1] 饶顺曾[1] 沈文龙[1] 

机构地区：[1]上海市徐汇区精神卫生中心,上海200232

出　　处：《中国民康医学》2011年第5期525-527,578,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨齐拉西酮与奥氮平治疗痴呆患者精神行为症状的疗效和不良反应。方法:将104例老年痴呆伴精神障碍患者分别给予齐拉西酮和奥氮平治疗,其中齐拉西酮组45例,奥氮平组59例,疗程共12周。采用阿尔茨海默病行为病理评定量表(Behave AD)、Cohen-Mansfield激惹性问卷(CMAI)评定临床疗效,在治疗前及治疗第6及12周末对血糖、血脂、心电图进行检测及分析。结果:(1)两组治疗后Behave AD和CMA I评分均显著下降(P<0.01),治疗后两组间疗效无显著性差异(P>0.05)。(2)齐拉西酮组治疗前后空腹血糖、总胆固醇及甘油三酯差异均无显著性(P>0.05),而奥氮平组治疗后血糖及TG水平明显升高,与治疗前比较均有显著性差异(P<0.05)。(3)治疗后两组间心电图异常发生率无显著性差异(P>0.05)。结论:齐拉西酮和奥氮平治疗老年痴呆伴精神障碍均有效,齐拉西酮对患者的血糖、血脂影响较奥氮平小。Objective ：To explore the efficacy and safety of Ziprasidone and Olanzapine to treat the behavioral and psychological symptoms of dementia （BPSD）. Methods：A total of 104 patients with BPSD were randomly divided into study group with Ziprasidone and control group with Olanzapine for treatment of 12 weeks. 45 treated with Ziprasidone and 59 treated with Olanzapine. Behavioral pathology in Alzheimer disease rating scale （Behave AD）, Cohen -mansfield agitation inventory （CMA I） were used. Patient＇s data were collected by the way of face - to - face questionnaire to patients, consulting patient＇s medical record. They were determined respectively for electrocardiogram, blood sugar and blood lipid in baseline, the 6th weekend and 12th weekend. Results： （ 1 ） after treatment, the total efficacious rate was 46.7% and 52.6% , showed no significant difference in two groups （ P 〉 0.05 ）. The Behave AD and CMA I scores in both groups decreased significantly after treatment （ all P 〈 0.01 ）. （2） In the 6th weekend and 12 the week- end after treatment, there were no differences for blood sugar and blood lipid in Ziprasidone group compared with the baseline （ P 〉 0. 05 ）. But after treatment, blood sugar and triglyceride （TG） level in Olanzapine group were both significantly higher than those in baseline （P 〈 0.05 ）. （3） There had no differences for the prevalence of electrocardiogram abnormality between two groups in the 12th weekend （ P 〈 0.05 ）. Conclusions ： Ziprasidone and Olanzapine have good efficacy in the treatment of BPSD, and Ziprasidone had fewer effects on glucose and lipid metabolism than Olanzapine.

关 键 词：痴呆的精神与行为症状(BPSD) 齐拉西酮 奥氮平 

分 类 号：R749.16[医药卫生—神经病学与精神病学]