喹硫平与利培酮治疗痴呆患者精神行为症状对照研究  

Randomized Trial of Quetiapine and Risperidone for Behavioral and Psychological Symptoms of Dementia

作　　者：袁菁[1] 邹凯[1] 蒋兴衍 徐清[1] 夏鸣华 赵彦[1] 

机构地区：[1]中国.江苏省无锡市精神卫生中心,214151

出　　处：《中国健康心理学杂志》2012年第11期1606-1608,共3页China Journal of Health Psychology

摘　　要：目的评价喹硫平与利培酮治疗阿尔茨海病患者精神行为症状(BPSD)的疗效及安全性。方法将54例伴有精神行为症状的阿尔茨海默病患者随机分为喹硫平组和利培酮组,疗程12周。采用神经精神问卷(NPI)评估治疗效果,阿尔茨海默病评价量表-认知分表(ADAS-Cog)评估治疗前后认知功能,并分别于0,1,2,4,6,8,10,12周评定药物副反应量表(TESS)。同时于治疗前后检测血清泌乳素(PRL)水平。结果治疗后两组NPI分值明显下降(t=2.02～4.39,P<0.05),但是ADAS-Cog升高(t=2.15和2.73,P<0.05)。喹硫平组治疗前后泌乳素水平改变不明显(t=1.10,P>0.05),而利培酮组泌乳素水平明显升高(t=3.97,P<0.05)。喹硫平组不良反应发生率为30.7%,未出现严重不良反应。利培酮组不良反应发生率为30.0%,其中1例出现意识障碍。结论喹硫平和利培酮均能改善BPSD,但喹硫平的安全性和耐受性优于利培酮。Objective To compare the efficacy and safety of quetiapine and risperidone in treating behavioral and psychological symptoms of dementia（BPSD）.Metheds A total of 54 Alzheimer＇s disease with BPSD were randomly assigned to receive quetiapine or risperidone for 12 weeks.BPSD was assessed with Neuropsychiatric Inventory（NPI）.The cognitive function was assessed with Alzheimer Disease Assessment Scale-Cognitive portion（ADAS-Cog）.Both scales were rated at baseline and end of the study.Treatment Emergent Symptom Scale（TESS）was used to assess the adverse effects.The prelactin（PRL）was measured at the baseline and the end of study.Results After treatment,patients＇ NPI scores decreased significantly in both groups（t=2.02～4.39,P0.05）,but the ADAS-Cog scores enhanced significantly（t=2.15,2.73,P0.05）.The PRL increased significantly as compared to the baseline in risperidone group（t=3.97,P0.05）,while there was no significantly difference from the baseline in quetiapine group（t=1.10,P0.05）.Overall,30.0% of risperidone group and 30.7% of quetiapine group reported adverse events.There was no severe side-effects appeard with quetiapine therapy,but one case appear disturbance of consciousness with risperidone therapy.Conclusion Both quetiapine and risperidone can improve BPSD.The tolerability and safety of quetiapine are better than those of risperidone.

关 键 词：痴呆 行为症状 喹硫平 利培酮 

分 类 号：R749.16[医药卫生—神经病学与精神病学]