美金刚治疗老年痴呆患者伴精神行为症状的对照研究  

Studying the effects of memantine on Alzheimer disease patients with behavioral and psychological symptoms

作　　者：曹江[1,2] 吴彦清[2] 周佳男[2] 杨建立[1,2] 

机构地区：[1]天津医科大学研究生院,天津300074 [2]天津市安定医院老年科

出　　处：《中国慢性病预防与控制》2016年第11期828-830,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的评价美金刚治疗老年痴呆(AD)患者伴发精神和行为症状(BPSD)的疗效及安全性,为此类患者的治疗提供依据。方法将2015年1月至2016年5月天津市安定医院老年科收治的90例老年痴呆且伴发BPSD的患者随机分为美金刚组与奥氮平组,治疗8周。在治疗前、治疗2周末、4周末和8周末,采用痴呆病理行为评定量表(BEHAVE-AD)评定疗效,简易精神状况检查量表(MMSE)评定患者认知功能,日常生活能力量表(ADL)评定患者生活质量,不良反应症状量表(TESS)评定不良反应。用SPSS 12.0统计软件进行统计学分析,计量资料的比较采用t检验,计数资料的比较采用χ2检验。结果美金刚组在治疗后第8周末BEHAVE-AD评分[(12.67±4.46)分]较奥氮平组[(15.78±5.75)分]显著下降,差异有统计学意义(t=2.74,P<0.01)。美金刚组在治疗后第8周末MMSE评分[(15.69±3.33)分]较治疗前[(13.62±4.45)分]显著升高,差异有统计学意义(t=2.42,P<0.05);奥氮平组MMSE评分治疗前[(13.35±4.19)分]与治疗2周末[(13.28±3.78)分]、4周末[(13.25±3.80)分]、8周末[(13.48±3.24)分]比较,差异均无统计学意义(t值分别为0.08、0.11和0.15,P>0.05);治疗第8周末,两组患者MMSE评分差异有统计学意义(t=3.05,P<0.01)。与治疗前[美金刚组:(41.02±8.89)分、奥氮平组:(41.43±9.45)分]比较,两组治疗后第8周末ADL评分[美金刚组:(35.05±7.25)分、奥氮平组:(36.15±7.94)分]均显著下降,差异均有统计学意义(t值分别为3.38和2.70,P<0.01);治疗第8周末,两组患者ADL评分比较,差异无统计学意义(t=0.66,P>0.05)。奥氮平组便秘、头昏头晕、锥体外系反应、嗜睡、体重增加方面的不良反应发生率明显高于美金刚组,差异均有统计学意义(P<0.05,P<0.01)。结论美金刚能够有效改善老年痴呆患者的精神和行为症状,而且安全性较好。此外,美金刚还能够改善患者的认知功能。Objective To evaluate the efficacy and safety of memantine on Alzheimer disease （AD） patients with behavioral and psychological symptoms （BPSD）. Methods From January of 2015 to May of 2016, 90 AD inpatients with BPSD were selected as the subjects, the subjects were divided into memantine group and olanzapine group, the subjects were treated with memantine and olanzapine for 8 weeks, respectively. Before treatment, in 2, 4 and 8 weeks after treatment BEHAVE-AD was used to assess the therapy efficacy, the cognition function of patients was assessed with Mini Mental State Examination （MMSE）, Activities of Daily Living Scale （ADL） and Treatment Emergent Symptoms Scale （TESS） were utilized to evaluate the efficacy and side effects of patients. The t test and X2 test were used to analyze the data. The used software was SPSS 12.0 software. Results In 8 weeks after treatment, the score of BEHAVE-AD in memantine group was 12.67±4.46, which was significantly lower than that （ 15.78±5.75 ） in olanzapine group （P0.01）; the score of MMSE in memantine group was 15.69±3.33, which was significantly higher than that （ 13.62±4.45 ） before treatment （P〈0.05）. Before treatment, in 2, 4 and 8 weeks after treatment the scores of MMSE in olanzapine group were 13.35±4.19, 13.28±3.78, 13.25±3.80 and 13.48±3.24, respectively, there were no significant differences. In 8 weeks after treatment, there was a significant difference of MMSE between two groups （P〈0.01）. The ADL scores （41.02-±8.89 and 41.43-±9.45） in memantine group and olanzapine group before treatment were significantly higher than those （35.05-±7.25 and 36.15-±7.94 ） in 8 weeks after treatment （P〈O.01 ）. But after treatment there was no significant difference of ADL between two groups. The rates of side effects such as constipation, dizziness, EPS, drowsiness, weight gain in olanzapine group were significantly higher than those in memantine group （P〈0.05 or P〈0.01 ）. Conclusion Memantine could improv

关 键 词：美金刚 奥氮平 老年痴呆 痴呆的行为和精神症状 

分 类 号：R181.3[医药卫生—流行病学]