硫酸镁治疗老年性谵妄的疗效观察Δ  

Efficacy of Magnesium Sulfate for Senile Delirium

作　　者：陈钊[1,2] 周国新 侯乐[3] 梁淑兰 宁玉萍[3] 

机构地区：[1]东莞市常平医院神经内科,广东东莞523573 [2]广州医学院,2011级硕士研究生广州510182 [3]广州医学院附属广州脑科医院,广州510180

出　　处：《中国医院用药评价与分析》2012年第8期728-731,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：广州市中医药科技项目(201122231038);广州市卫生局一般引导项目(201102A213183)

摘　　要：目的:观察老年性谵妄患者的血清镁离子(Mg2+)浓度变化以及探讨硫酸镁对老年性谵妄的治疗作用。方法:40例老年性谵妄患者以随机表法分为研究组和对照组各20例,对照组患者按常规治疗原发病和用地西泮注射液控制谵妄症状;研究组患者在对照组的基础上,加用硫酸镁溶液滴注治疗。检测2组患者治疗前、治疗后3、7 d的血清Mg2+浓度、谵妄症状评分、地西泮的用量、不良反应情况等,对数据进行统计学分析。结果:治疗前研究组和对照组患者血清Mg2+浓度均较低,分别为(0.68±0.07)、(0.66±0.04)mmol.L-1;治疗后3 d,研究组患者血清Mg2+浓度显著高于对照组,分别为(1.00±0.07)、(0.78±0.05)mmol.L-1,2组比较差异有统计学意义(P<0.01);治疗后7 d,2组患者血清Mg2+浓度基本回落至正常。按谵妄评分量表中文修订版(CAM-CR)评分持续48 h低于19分为终点,研究组患者谵妄症状持续时间为(2.8±1.5)d,对照组为(4.8±1.5)d,2组相差(1.2±1.5)d,差异有统计学意义(P=0.02);研究组地西泮的用量为(10.0±7.6)mg,对照组为(18.5±10.4)mg,2组相差(8.5±11.3)mg,差异有统计学意义(P=0.005)。结论:老年性谵妄患者的血清Mg2+浓度与病情进展相关。硫酸镁用于老年性谵妄的患者,可缩短病程,减少地西泮的用量,效果确切,但要注意给药速度、浓度和总剂量。OBJECTIVE：To observe the change of serum concentration of magnesium （Mg^2＋ ） in senile delirium patients and evaluate the efficacy of magnesium sulfate for senile delirium. METHODS： 40 patients with senile delirium were randomly assigned to either control group or trial group of 20 each. The control group received therapyfor management of primary diseases plus diazepam for management of delirium symptoms, whereas the trial group received add-on Adlerikas plus the therapies for the control group. The data such as serum concentration of magnesium （Mg^2＋ ） , scores of confusion symptom, dose of diazepam and adverse drug reactions in the two groups were recorded before treatment and at 3 and 7 days of treatment and the data were analyzed statistically. RESULTS ： Before treatment, the serum concentration of magnesium was [ （0. 68 ± O. 07 ） mmol. L^- 1 ] for the treatment group vs. [ （ 0. 66±O. 04） mmol. L^-1 ] for the control group, as compared with [ （ 1.00 ± 0. 07） mmol^ L-1 ] vs. [ （0. 78 ± 0. 05） mmol. L^- 1] after treatment, showing statistically significant differences between the two groups （P 〈 0. 01 ）. Serum magnesium concentrations in both groups reverted to normal levels at 7 days. The end point was defined as CAM-CR （Confusion assessment method Chinese reversion） scores of less than 19 for 48 hours, with delirium symptom lasting for （2. 8 ± 1.5） days in trial group vs. （d. 8 ± 1.5 ） days in control group, showing a difference of （ 1.2 ± 1.5 ） days between the two groups （P =0. 02）. The dose of diazepam for the trial group was （10. 0 ± 7.6） mg vs. （ 18.5± 10. 4） mg for the control group, showing a difference of （8.5 ± 11.3 ） mg between the two groups （P = 0. 005 ）. CONCLUSION ： Serum concentration of magnesium in senile delirium patients is associated with patients＇ pathogenetic condition. Treatment of senile delirum using magnesium sulfate resulted in shorter course of treatment, lower needed dose of diazepam and prov

关 键 词：硫酸镁 老年性谵妄 血清镁离子浓度 疗效观察 

分 类 号：R749.16[医药卫生—神经病学与精神病学]