阿立哌唑和奥氮平治疗老年痴呆叠加不同亚型谵妄的对照研究  

Aripiprazole and olanzapine on senile dementia of the alzheimer type:A control study

作　　者：李平[1] 徐曼华[1] 何兰英 王立峰[1] 张培[1] 宋丽华[1] Li Ping;Xu Manhua;He Lanying;Wang Lifeng;Zhang Pei;Song Lihua(Department of Mental Health,the Eighth Hospital of Shijiazhuang,Shijiazhuang 050081,China)

机构地区：[1]石家庄市第八医院精神卫生科,河北石家庄050081

出　　处：《临床荟萃》2022年第8期699-703,共5页Clinical Focus

基　　金：石家庄市科学技术研究与发展计划项目——老年精神障碍患者发生谵妄的影响因素相关分析与治疗(201461123)。

摘　　要：目的 比较阿立哌唑和奥氮平治疗老年痴呆叠加不同亚型谵妄的有效性和安全性。方法 纳入2020年11月-2021年11月于石家庄市第八医院确诊的老年痴呆叠加谵妄的患者86例。随机分为观察组和对照组,根据谵妄病因两组均给予基础支持治疗,观察组在此基础上给予阿立哌唑口服或舌下含服治疗,起始剂量2.50mg/d,后剂量调整为2.50~10.00mg/d。对照组给予奥氮平口服或舌下含服治疗,起始剂量1.25mg/d,后剂量调整为1.25~10.00mg/d。比较两组老年痴呆叠加不同亚型谵妄的临床疗效与安全性。结果 观察组痴呆叠加低活动型谵妄患者治疗有效率优于对照组(P<0.05);两组痴呆叠加高活动型、混合型谵妄患者治疗有效率差异无统计学意义(均P>0.05)。两组在观察期内均无因严重不良反应中断治疗的情况发生。结论 阿立哌唑和奥氮平均可以安全地用于老年痴呆叠加谵妄的患者,对于叠加低活动型谵妄患者低剂量的阿立哌唑临床疗效优于奥氮平,患者对于低剂量短疗程的阿立哌唑和奥氮平耐受性均较好。Objective To assess the effectiveness and safety of aripiprazole and olanzapine on senile dementia of the alzheimer type(SDAT). Methods A total of 86 SDAT patients visited in the Eighth Hospital of Shijiazhuang from November 2020 to November 2021 were enrolled and randomly assigned into the observation group and the control group. The patients were managed by supportive treatment based on etiology of delirium, the observation group was treated with oral or sublingual administration of aripiprazole at dose range 2.50-10.00 mg/d, and the control group with olanzapine at dose range 1.25-10.00 mg/d. The aiming was to compare the clinical efficacy and safety.Results The treatment efficiency of patients with hypoactive SDAT in the observation group was better than that in the control group(P<0.05). The difference was not statistically significant in the treatment efficiency of hyperactive SDAT and mixed SDAT between groups(all P>0.05). There was no interruption of treatment due to serious adverse reactions in both groups during the observation period. Conclusion For SDAT patients, aripiprazole and olanzapine are safe to use. The low-dose aripiprazole is superior to olanzapine for hypoactive SDAT patients. Moreover, both low-dose, short-course of aripiprazole and olanzapine were well tolerated for these patients.

关 键 词：痴呆 谵妄 阿立哌唑 奥氮平 

分 类 号：R749.16[医药卫生—神经病学与精神病学]