奥氮平治疗对老年期痴呆伴精神障碍患者血清25-羟维生素D、Hcy、IGF-1及BDNF水平的影响  

The effects of olanzapine therapy on serum 25-hydroxyvitamin D, Hcy, IGF-1,and BDNF levels of elderly patients with mental disorders and dementia

作　　者：江建忠 买买提热夏提·吐尔逊[1] 赵尚尚 JIANG Jian-zhong;MAIMAITI Turzon;ZHAO Shang-shang(Department of Gerontology,the Fourth People's Hospital of Urumqi,Urumqi 830002,xinjiang Uygur Autonom Autonomous Region,China)

机构地区：[1]新疆维吾尔自治区乌鲁木齐市第四人民医院老年科

出　　处：《世界临床药物》2019年第6期431-436,共6页World Clinical Drug

摘　　要：目的观察奥氮平治疗对老年期痴呆伴精神障碍患者血清25羟维生素D(25-hydroxyvitamin D,25-OH-VD)、同型半胱氨酸(homocysteine,Hcy)、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)及脑源性神经营养因子(brain derived neurotrophic factor,BDNF)水平的影响。方法将148例老年期痴呆伴精神障碍患者随机分为奥氮平组及利培酮组,每组74例。奥氮平组给予奥氮平片治疗,利培酮组给予利培酮片治疗,均持续治疗1个月,比较两组患者治疗后的临床效果,并按阿尔茨海默病病理行为评分表(behavioral pethology in Alzheimer’s disease rating scale,BEHAVE-AD)、简易精神状态量表(minimental state examination,MMSE)评估患者症状改善情况,检测老年期痴呆伴精神障碍患者血清25-OH-VD、Hcy、IGF-1及BDNF水平,观察不良反应发生情况。结果治疗后,两组患者BEHAVE-AD评分显著降低(P <0.01),且奥氮平组BEHAVE-AD评分显著低于利培酮组(P <0.01);两组患者MMSE评分显著升高(P <0.01),且奥氮平组MMSE评分显著高于利培酮组(P <0.01);奥氮平组治疗后总有效率为90.54%,显著高于利培酮组74.32%(P <0.05);两组患者治疗后血清25-OH-VD、BDNF水平均显著高于治疗前(P <0.01),且奥氮平组患者血清25-OH-VD、BDNF水平显著高于利培酮组(P <0.01);两组患者治疗后患者血清Hcy、IGF-1水平均显著低于治疗前(P <0.01),且奥氮平组患者血清Hcy、IGF-1水平显著低于利培酮组(P <0.01);两组患者治疗后利培酮组TC、TG水平显著高于治疗前(P <0.05),奥氮平组TG水平显著高于治疗前(P <0.01),且利培酮组TG水平显著高于奥氮平组(P <0.05)。奥氮平组不良反应发生率为14.68%,显著低于利培酮组31.08%(P <0.05)。结论奥氮平治疗老年期痴呆伴精神障碍患者疗效显著,可明显增加血清25-OH-VD、BDNF表达水平,降低血清Hcy、IGF-1表达水平,且对血糖影响较小,不良反应较少,值得进一步推广使用,但可能引起血脂代谢�Objective To observe the effects of olanzapine on serum 25-hydroxyvitamin D(25-OH-VD), homocysteine(Hcy), insulin-like growth factor-1(IGF-1), and brain-derived neurotrophic factor(BDNF) levels in elderly patients with mental disorders and dementia. Methods A total of 148 dementia in elderly patients with mental disorders were randomly divided into olanzapine group and risperidone group, 74 casein each group. Olanzapine group was treated with olanzapine tablets, and risperidone group was treated with risperidone tablets. Both groups were treated for one month. The clinical effects of two groups were compared. Behavioral pethology in Alzheimer’s disease rating scale(BEHAVE-AD) and minimental state examination(MMSE) were used to valuate the improvement serum 25-OH-VD, Hcy, IGF-1, BDNF levels in dementia in elderly patients with mental disorders were measured and monitor the occurrence of adverse reactions. Results After treatment, the BEHAVE-AD scores of the two groups decreased significantly(P<0.01), and the BEHAVE-AD score of olanzapine group was significantly lower than risperidone group(P<0.01), after treatment, the MMSE score of the two groups increased significantly(P<0.01), and the MMSE score of olanzapine group was significantly higher than risperidone group(P<0.01), the total effective rate of olanzapine group was 90.54%, which was significantly higher than 74.32% of risperidone group(P<0.05), the serum 25-OH-VD and BDNF levels of the two groups were significantly higher than those before treatment(P<0.01), and the levels of serum 25-OH-VD and BDNF in olanzapine group were significantly higher than those in risperidone group(P<0.01), the serum Hcy and IGF-1 levels of the two groups were significantly lower than those before treatment(P<0.01), and the levels of serum Hcy and IGF-1 in olanzapine group were significantly lower than those in risperidone group(P<0.01). The levels of TC and TG in the risperidone group were significantly higher in the two groups after treatment than before treatment(P<0.05). Th

关 键 词：奥氮平 老年期痴呆伴精神障碍 25羟维生素D 同型半胱氨酸 胰岛素样生长因子-1 脑源性神经营养因子 

分 类 号：R749[医药卫生—神经病学与精神病学] R971.4[医药卫生—临床医学]