多奈哌齐合并奥氮平治疗以精神行为症状首发的阿尔茨海默病患者的临床研究  

Olanzapine combined with donepezil in treatment of behavioral and psychiatric symptoms in patients with Alzheimer' s disease

作　　者：章瑜[1] 谢健[1] ZHANG Yu;XIE Jian(Department of Clinical Psychologyt Hangzhou First People's Hospital, Hangzhou 3100061 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》2016年第24期1997-1999,2010,共4页Zhejiang Medical Journal

基　　金：杭州市卫生科技项目(2012A006);浙江省医药卫生科技计划项目(2013k YA161)

摘　　要：目的观察多奈哌齐合并不同剂量奥氮平对首发以精神行为症状(BPSD)就诊的阿尔茨海默病(AD)的疗效和不良反应。方法对70例以精神行为症状为首发的AD患者按随机数字表法分为多奈哌齐合并5mg奥氮平组和多奈哌齐合并10mg奥氮平组,每组35例。以神经精神科问卷(NPI)评定患者BPSD,以简易精神状态量表(MMSE)评估患者认知功能,并在4周和8周随访1次,并以不良反应量表(TESS)评估8周后的药物不良反应。结果两组8周后MMSE分值较治疗前明显增加,而NPI分值明显减少,差异均有统计学意义(均P<0.05),10mg组8周后的MMSE及NPI量表分值改变较5mg组更加明显(P<0.05)。10mg组的嗜睡发生率较5mg组高,差异有统计学意义(P<0.01)。结论多奈哌齐联合奥氮平10mg对治疗AD患者BPSD效果较好,能进一步改善其认知功能,但是在临床上应用应注意药物不良反应。Objective To investigate the efficacy and side effects of olanzapine combined with donepezil in treatment of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD). Methods Seventy AD patients with BPSD admitted from February 2015 to February 2016 were divided into two groups: 35 patients received olanzapine 5mg and donepezil 5mg (group A) and another 35 patients received olanzapine 10mg and donepezil 5mg (group B). The psychiatric symptoms and cognitive function were evaluated with Neuropsychiatric Inventory (NPI) and Mini-Mental State Examination (MMSE) in two groups 4 and 8 weeks after treatment, respectively. Treatment Emergent Symptom Scale (TESS) wasused to assess side effects 8 weeks after treatment. Results MMSE varieties were significantly improved at 8 weeks after treatment in both groups (P<0.05) . The improvement of MMSE and NPI scores in group B was more markedly than that in group A 8 weeks after treatment (P<0.05). The incidence rate of insomnia in group B was higher than that in group A (P<0.01).Conclusion Olanzapine 10 mg combined donepezil is more effective than 5mg in treatment of AD patients with BPSD, but it has more side effects.

关 键 词：奥氮平 多奈哌齐 阿尔茨海默病 精神行为症状 不良反应 疗效 

分 类 号：R749.16[医药卫生—神经病学与精神病学]