美金刚对阿尔茨海默病患者精神行为症状和睡眠结构的影响  

Effect of memantine on sleep disturbance in Alzheimer's disease patients with behavioral and psychological symptoms

作　　者：章瑜[1] 谢健[1] ZHANG Yu;XIE Jian(Department of Psychiatry,Hangzhou First People＇s Hospital,Hangzhou 310006,China)

机构地区：[1]杭州市第一人民医院临床心理科,310006

出　　处：《浙江医学》2018年第11期1175-1178,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2013KYA161);杭州市科技局项目(20170533B36);杭州市卫生科技项目(2012A006)

摘　　要：目的观察美金刚对伴有精神行为症状(BPSD)的阿尔茨海默病(AD)患者睡眠结构的影响。方法将30例以BPSD为首发的AD患者,以神经精神科问卷(NPI)了解患者BPSD的变化,以简易精神状态量表(MMSE)评估患者认知功能,以多导睡眠仪(PSG)评估睡眠质量,并在入院初始剂量起给予美金刚10mg/d,逐渐加至20mg/d,治疗4周后给予再次评估和PSG检查。结果经过美金刚治疗后MMSE评分未见显著增加,而NPI得分较前显著下降。美金刚能显著减少妄想、幻觉、激越、焦虑、脱抑制和睡眠障碍的评分。PSG数据显示:总睡眠时间显著延长,睡眠效率显著增加,睡眠潜伏期显著缩短,阶段Ⅱ睡眠占总睡眠时间比显著增加。结论美金刚能有效改善AD的BPSD并有效改善睡眠结构和质量。Objective To assess the effect of memantine on sleep disturbance in Alzheimer＇s disease（AD） patients with behavioral and psychological symptoms of dementia（BPSD）. Methods Thirty AD patients with BPSD as initial symptoms were enrolled in this study.The Neuropsychiatric Inventory（NPI） was used to assess psychiatric symptoms, Mini-Mental State Examination（MMSE） was used to evaluated the cognitive function and polysomnography（PSG） was used to examine the sleep architecture before and after treatment. According to a standard prescription protocol patients received memantine 10 mg/d as initial dose, then gradually increased to 20 mg/d in 1 week, and the treatment lasted for 4 weeks. Results Twenty one patients completed the therapy. Compared with the baseline results, MMSE scores were not significantly increased, while the NPI scores were significantly decreased（P〈0.01） after treatment. The scores of delusion（P〈0.01）,hallucination（P〈0.01）, agitation（P〈0.05）, anxiety（P〈0.05）, disinhibition（P〈0.05） and sleep disorder（P〈0.05） were significantly decreased. PSG indicated that the total sleep time（TST） was significantly prolonged, sleep efficiency（SE） were significantly increased, sleep latency（SL） was significantly shortened, and time spent in stage Ⅱ（Ⅱ % TST） was significantly increased. Conclusion Memantine can effectively improve the symptoms and increase the sleep quality in AD patients with BPSD.

关 键 词：美金刚 阿尔茨海默病 精神和行为症状 多导睡眠仪 治疗 

分 类 号：R749.16[医药卫生—神经病学与精神病学]