奥氮平及利培酮治疗老年痴呆精神行为症状的疗效及安全性研究  

Eficacy and safety of olanzapine or risperidone in the treatment of behavioral and psychological symptoms of dementia

作　　者：蒋文竹 沙江明[1] 刘澄英[1] 

机构地区：[1]东南大学医学院附属江阴人民医院老干部科,江苏省无锡市214400

出　　处：《实用老年医学》2015年第8期679-681,共3页Practical Geriatrics

摘　　要：目的探讨奥氮平及利培酮治疗老年痴呆精神行为症状的疗效和安全性。方法将120例老年痴呆患者随机分为3组:奥氮平组、利培酮组、安慰剂组,治疗前和研究结束时评估其简易智力状态检查(MMSE)评分。在治疗后的第2、4、6、8周末以痴呆病理行为评定量表(BEHAVE-AD)减分率评定疗效,以不良反应量表(TESS)记录治疗中各组药物不良反应。结果治疗结束后奥氮平组、利培酮组MMSE评分均较治疗前显著提高,差异有统计学意义(P均<0.05),奥氮平组和利培酮组治疗第4周末时BEHAVE-AD量表评分均明显下降,差异有统计学意义(P均<0.05),安慰剂组治疗前后量表评分均无明显变化。奥氮平组有效率为86.84%(33/38);显著有效率为65.79%(25/38)。利培酮组有效率为86.48%(32/37);显著有效率为64.86%(24/37),2组间疗效比较差异无统计学意义(P均>0.05),安慰剂组有效率为12.50%(5/40),显著有效率为0,奥氮平组和利培酮组均无不能耐受的药物不良反应。结论奥氮平及利培酮治疗老年痴呆精神行为症状安全有效。Objective To investigate the efficacy and safety of olanzapine or risperidone in the treatment of behavioral and psychological symptoms of dementia.Methods 120 patients with behavioral and psychological symptoms of dementia were randomly divided into 3 groups：olanzapine group,risperidone group and control group.The mini-mental state examination（MMSE） scores were evaluated before treatment and at the end of the study.The efficacy was evaluated 2,4,6,8 weeks after treatment by reduced rate of the behavioral pathology in Alzheimer＇s disease scale（BEHAVE-AD）.The treatment emergent symptom scale（TESS） was used to record the adverse reactions.Results After treatment,the scores of MMSE were significantly increased in olanzapine group and risperidone group（all P〈0.05）.Four weeks after treatment,the scores of BEHAVE-AD in olanzapine group and risperidone group were significantly decreased（P〈0.05）.The effective rate and the markedly effective rate of olanzapine group was 86.84%（33/38） and 65.79%（25/38）,compared with86.48%（32/37） and 64.86%（24/37） in risperidone group,12.5%（5/40） and 0（0/40） in control group.There were no intolerant adverse reactions in all groups.Conclusions Olanzapine and risperidone are safe and effective in the treatment of dementia complicated with behavioral and psychological symptoms.

关 键 词：奥氮平 利培酮 老年痴呆精神行为症状 

分 类 号：R749.16[医药卫生—神经病学与精神病学]