氢溴酸加兰他敏片对阿尔茨海默病患者血清乙酰胆碱酯酶水平的影响及临床疗效探究  

Effect of galantamine hydrobromide tablets on serum acetylcholinesterase level and its clinical efficacy in patients with Alzheimer′s disease

作　　者：孙金燕 黄大伟 唐新宁[3] Sun Jinyan;Huang Dawei;Tang Xinning(Department of Clinical Laboratory,the Third Hospital of Chaoyang District,Beijing 100025,China;Department of Clinical Laboratory,Beijing Longfu Hospital,Beijing 100001,China;Department of Clinical Laboratory,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]北京市朝阳区第三医院检验科,北京100025 [2]北京市隆福医院检验科,北京100001 [3]中国中医科学院望京医院检验科,北京100102

出　　处：《实用药物与临床》2023年第5期413-417,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的探寻氢溴酸加兰他敏片对阿尔茨海默病(AD)患者血清乙酰胆碱酯酶(AchE)水平的影响和临床疗效。方法选取2022年3-12月于北京市隆福医院确诊为阿尔茨海默病的患者共100例。利用简单随机分配法,将接受此次研究的100例AD患者分为治疗组(50例)和安慰剂组(50例)。所有患者均接受常规治疗和认知康复训练治疗,治疗组患者服用氢溴酸加兰他敏片(初始剂量为5 mg/次,4次/d,3 d后增加药量至10 mg/次,4次/d),安慰剂组患者给予同等剂量的安慰剂(糖果)进行安慰治疗。比较两组患者治疗前后的认知功能、日常生活能力水平、焦虑抑郁症状的严重程度、血清乙酰胆碱酯酶水平、临床疗效以及用药后的不良反应。结果治疗组总有效率(94%)高于安慰剂组(80%),差异具有统计学意义(P<0.05)。治疗前,安慰剂组和治疗组患者的MoCA评分、MMSE评分、ADL评分分别为(20.18±2.50 vs.20.63±2.37)、(18.20±2.45 vs.18.03±2.11)、(48.37±3.43 vs.48.23±3.15),治疗后,安慰剂组和治疗组的MoCA评分、MMSE评分、ADL评分分别为(23.98±2.16 vs.27.11±2.21)、(22.07±2.10 vs.25.03±2.58)、(56.99±3.31 vs.67.99±3.11),治疗后两组各项评分均较治疗前提高(P<0.05),且治疗组高于安慰剂组(P<0.05);治疗前,安慰剂组和治疗组的HAMA评分、HAMD评分分别为(17.48±3.74 vs.17.60±3.57)、(18.15±2.94 vs.18.46±2.83),治疗后,安慰剂组患者和治疗组患者的HAMA评分、HAMD评分分别为(14.54±3.23 vs.6.74±3.40)、(14.54±3.85 vs.7.44±3.43),两组患者治疗后焦虑及抑郁的严重程度较治疗前降低(P<0.05),且治疗组的评分低于安慰剂组(P<0.05);治疗前,安慰剂组和治疗组患者的血清乙酰胆碱酯酶水平分别为(23.26±3.50)mmol/L、(23.39±3.10)mmol/L,治疗后分别为(19.85±2.29)mmol/L、(17.85±2.30)mmol/L,两组患者治疗后血清AchE水平较治疗前降低(P<0.05),且治疗后治疗组患者的血清AchE水平明显低于安慰剂组患者(P<0.0Objective To observe the efficacy of evolocumab in patients with extremely high-risk atherosclerotic cardiovascular disease(ASCVD).Methods From October 2020 to July 2022,54 patients with confirmed extremely high-risk atherosclerotic cardiovascular disease who received treatment in Xianghongqi Outpatient Department of Jingxi Medical District of PLA General Hospital were selected.All of them were treated with moderate-intensity statins combined with ezeimibe lipid-lowering therapy,and their low-density lipoprotein cholesterol(LDL-C)was not up to standard.The enrolled patients were randomly divided into the statin enhanced group(27 cases)and the evolocumab group(27 cases).The treatment regimen of the statin enhanced group was adjusted to atorvastatin calcium 30 mg oral qd or rosuvastatin calcium 15 mg oral qd,while the original regimen of ezetimibe 10 mg oral qd was continued.In the evolocumab group,ezetimibe in the original regimen was changed to evolocumab 140 mg subcutaneous q2w,and the original regimen was continued with atorvastatin calcium 20 mg oral qd or rosuvastatin calcium 10 mg oral qd.Both groups were treated for 3 months.Changes in total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and LDL-C levels before and after treatment were observed,and adverse reactions were recorded.Results After treatment,LDL-C was(0.85±0.09)mmol/L in evolocumab group and(1.92±0.19)mmol/L in statin enhanced group.LDL-C was significantly decreased in both groups compared with before treatment,and the effect was more significant in the evolocumab group,the difference being statistically significant(P<0.05),but the effect of lowering TG and increasing HDL-C was better in statin enhanced group(P<0.05).The adverse reactions of the two groups were mild and transient,the treatment being generally safe.Conclusion In this study,the effect of evolocumab on lowering LDL-C in extremely high-risk ASCVD patients with substandard blood lipids is obvious,and all patients reach the standard.

关 键 词：阿尔茨海默病 氢溴酸加兰他敏 认知康复训练 血清乙酰胆碱酯酶 

分 类 号：R749.16[医药卫生—神经病学与精神病学]