美金刚与多奈哌齐治疗阿尔茨海默病患者的临床疗效比较  

Compare the clinical efficacy of memantine and donepezil in the treatment of Alzheimer's disease

作　　者：曾丝丝 廖恒[1] 赵学青 ZENG Sisi;LIAO Heng;ZHAO Xueqing(Department of Pharmacy,the Fourth People's Hospital of Chengdu,Chengdu,Sichuan,610000,China)

机构地区：[1]成都市第四人民医院药剂科,四川成都610000

出　　处：《当代医学》2023年第14期60-64,共5页Contemporary Medicine

摘　　要：目的比较美金刚与多奈哌齐治疗阿尔茨海默病(AD)的临床疗效。方法选取2019年1月至2020年9月于本院治疗的248例AD患者作为研究对象,按照随机数表法分为美金刚组与多奈哌齐组,各124例。美金刚组给予美金刚片治疗,多奈哌齐组给予盐酸多奈哌齐片治疗。比较两组治疗前后精神行为症状[神经精神科问卷(NPI)]、认知功能[阿尔茨海默病评估量表-认知维度(ADAS-Cog)、临床访问基础印象变化量表(CIBIS-plus)]、日常生活能力[日常生活能力量表(ADL)]、血清生化指标[脑源性神经生长因子(BDNF)、肿瘤坏死因子-α(TNF-α)、趋化因子配体2(CCL2)]及药物不良反应发生情况。结果治疗前,两组严重程度、发生频率、困扰程度评分比较差异无统计学意义;治疗4个月后,两组严重程度、发生频率、困扰程度评分均低于治疗前,且美金刚组低于多奈哌齐组,差异有统计学意义(P<0.05)。治疗前,两组ADAS-Cog、CIBIC-plus评分比较差异无统计学意义;治疗4个月后,两组ADAS-Cog、CIBIC-plus评分低于治疗前,且美金刚组低于多奈哌齐组,差异有统计学意义(P<0.05)。治疗前,两组躯体生活自理(PSM)、工具性日常生活活动(IADL)评分及总分比较差异无统计学意义;治疗4个月后,两组PSM、IADL评分及总分均低于治疗前,且美金刚组低于多奈哌齐组,差异有统计学意义(P<0.05)。治疗前,两组血清BDNF、TNF-α、CCL2水平比较差异无统计学意义;治疗4个月后,两组血清BDNF水平均高于治疗前,血清TNF-α、CCL2水平均低于治疗前,且美金刚组血清BDNF水平高于多奈哌齐组,血清TNF-α、CCL2水平均低于多奈哌齐组,差异有统计学意义(P<0.05)。两组药物不良反应发生率比较差异无统计学意义。结论美金刚可有效改善AD患者精神行为症状、认知功能、日常生活能力及相关血清生化指标,较多奈哌齐治疗效果更为理想,药物安全性良好,有利于患者预后�Objective To compare the clinical efficacy of memantine and donepezil in the treatment of Alzheimer's disease(AD).Methods 248 AD patients treated in our hospital from January 2019 to September 2020 were selected as the study subjects,they were divided into the memantine group and donepezil group according to the random number table method,with 124 cases in each group.The memantine group received treatment with memantine tablets,while the donepezil group received treatment with donepezil hydrochloride tablets.The psychiatric and behavioral symptoms(neuropsychiatric inventory[NPI]),cognitive function(Alzheimer's disease assessment scale-cognitive subscale[ADAS-Cog],clinicians'interview based impression of change scale-plus[CIBIS-plus]),daily living abilities(daily living ability scale[ADL]),serum biochemical markers(brain-derived growth factor[BDNF],tumor necrosis factor-α[TNF-α],chemokine ligand 2[CCL2])before and after treatment and the occurrence of adverse drug reactions were compared between the two groups.Results Before treatment,there were no significant differences in the severity,frequency and distress between the two groups;after 4 months of treatment,the severity,frequency and distress scores of the two groups were lower than before treatment,and memantine group was lower than the donepezil group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in ADAS-Cog and CIBIC-plus scores between the two groups;after 4 months of treatment,the ADAS-Cog and CIBIC-plus scores of the two groups were lower than before treatment,and the memantine group was lower than the donepezil group,the differences were statistically significant(P<0.05).Before treatment,there were no significant difference in physical self-mainte(PSM),instrumental activity of daily living(IADL)scores and total scores between the two groups;after 4 months of treatment,PSM,IADL scores and total scores of the two groups were lower than before treatment,and the memante hydrochloride group was

关 键 词：美金刚 多奈哌齐 阿尔茨海默病 精神行为症状 日常生活能力 

分 类 号：R749.16[医药卫生—神经病学与精神病学]