胆碱酯酶抑制剂联合谷氨酸受体拮抗剂和降血脂药三联疗法治疗血管性痴呆的疗效观察及安全性评估  

The Safety and Effects of Cholinesterase Inhibitor Combined with Glutamate Receptor Antagonists and Lipid-lowering Drugs on Vascular Dementia

作　　者：周燚炎 程卫东[1] 孙晓芬[1] 杨光[1] 颜建胜 

机构地区：[1]兰州大学中西医结合研究所,甘肃省兰州市730000

出　　处：《中国全科医学》2013年第35期4160-4162,共3页Chinese General Practice

摘　　要：目的探讨胆碱酯酶抑制剂联合谷氨酸受体拮抗剂、降血脂药三联疗法治疗血管性痴呆的临床疗效及安全性。方法将湖南省湘西自治州精神病医院康复中心2010年3月—2013年3月收治的60例血管性痴呆患者按用药不同分为对照组和治疗组各30例,其中治疗组在基础用药的基础上加用美金刚、阿托伐他汀和多奈哌齐;对照组加用多奈哌齐。两组治疗前后分别用简易精神认知量表(MMSE)、行为量表(Blessed-Roth)、日常生活能力量表(ADL)评定疗效,用药物副反应量表(TESS)评定用药安全性。结果治疗后治疗组MMSE评分较对照组升高,ADL和Blessed-Roth评分较对照组降低,差异均有统计学意义(P<0.05)。治疗组总有效率较对照组高(83.3%和53.3%),差异有统计学意义(χ2=6.239,P<0.05)。两组治疗后TESS评分比较差异无统计学意义(P>0.05)。结论胆碱酯酶抑制剂联合谷氨酸受体拮抗剂、降血脂药三联用药治疗血管性痴呆可以显著提高临床疗效,且联合用药不会影响其安全性。Objective To explore the safety and effects of cholinesterase inhibitor combined with glutamate receptor antagonists and lipid - lowering drugs on vascular dementia. Methods Sixty patients with vascular dementia treated in the Reha- bilitation Center of Psychiatric Hospital in Xiangxi Autonomous Prefecture of Hu＇nan were included in this study. They were ran- domly divided into two groups. The treatment group （ n = 30 ） received the triple therapy （ Donepezil ＋ Memantine ＋ Atorvasta- tin） , while the control group （n = 30） received Donepezil. The treatment lasted for 6 months. Patients were assessed by mini - mental state examination （MMSE） , activity of daily living scale （ADL） , Blessed- Roth dementia scale （BRDS） , and treat- ment emergent symptom scale （TESS） before and after the 6 -month treatment. Results Compared to the control group, the treatment group had significantly higher score of MMSES and lower scores of ADL and BRDS （ P 〈 0. 05 ） , and no significant difference were found in TESS scores between the two groups （ P 〉 0. 05 ）. The overall effective rate in treatment group was signif- icantly higher than that in control group （ 83.3% vs. 53.3% ; X2 = 6. 239, P 〈 0. 05 ）. Conclusion Combined use of cholines- terase inbibitors, glutamate receptor antagonist and lipid -lowering drugs is an effective and safe treatment for vascular dementia.

关 键 词：药物疗法 联合 痴呆 血管性 治疗结果 危险性评估 

分 类 号：R743[医药卫生—神经病学与精神病学]