喹硫平对阿尔茨海默病患者精神行为症状,认知功能及神经递质的影响  

Effect of quetiapine on psychobehavioral symptoms,cognitive function and neurotransmitters in patients with Alzheimer's disease

作　　者：张淑艳 赵倩 孙蜀宁 ZHANG Shuyan;ZHAO Qian;SUN Shuning(Department of Neurology,Jinqiu Hospital,Liaoning Province,Shenyang 110016,China)

机构地区：[1]辽宁省金秋医院神经内科,沈阳110016

出　　处：《国际精神病学杂志》2024年第4期1189-1193,共5页Journal Of International Psychiatry

基　　金：辽宁省省直医院改革重点临床科室诊疗能力建设项目(编号:LNCCC-D39-2015)。

摘　　要：目的分析喹硫平对阿尔茨海默病(Alzheimer's disease,AD)患者精神行为症状(behavioral psychological symptoms of dementia,BPSD),认知功能及神经递质的影响。方法选择2020年1月~2022年12月我院收治的AD患者90例纳入研究,按随机数字表法分为试验组,对照组,各45例。对照组接受盐酸美金刚治疗,试验组在盐酸美金刚基础上增加喹硫平,两组均治疗3个月,比较两组治疗3个月后疗效,治疗前,治疗3个月后BPSD,认知功能,生活能力,心电图及神经递质水平,治疗期间不良反应发生情况。结果治疗3个月后,试验组总有效率在两组中更高(84.44%vs 62.22%,P<0.05)。与治疗前比较,治疗3个月后两组阿尔茨海默病病理行为评分,简明精神病评定量表评分,神经精神科问卷,AD认知功能评价量表评分降低,日常生活能力量表评分均下降,且试验组更低(P<0.05)。与治疗前比较,治疗3个月后两组心电图指标比较差异无统计学意义(P>0.05)。与治疗前比较,治疗3个月后,两组简易精神状态量表评分,血清去甲肾上腺素,多巴胺,5-羟色胺水平均升高,且试验组更明显(P<0.05)。治疗期间,两组不良反应发生率比较,差异无统计学意义(15.56%vs 20.00%,P>0.05)。结论喹硫平联合盐酸美金刚可控制AD患者BPSD,促进认知功能恢复,改善生活质量,且加用药物并未增加心电图指标变化,安全性良好。Objective To analyze the effects of behavioral psychological symptoms of dementia(BPSD),cognitive function and neurotransmitters in patients with Alzheimer's disease(AD).Methods 90 patients with AD treated in our hospital from January 2020 to December 2022 were included in the study and divided into the experimental group and the control group,45 cases in each group,using random number table method.The control group was treated with Memantine hydrochloride,and the experimental group was treated with quetiapine on the basis of Memantine hydrochloride.Both groups were treated for 3 months.The effects after 3 months of treatment,BPSD,cognitive function,quality of life,electrocardiogram and neurotransmitters before and after 3 months of treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results After 3 months of treatment,the total response rate was higher in the experimental group(84.44%vs 62.22%,P<0.05).After 3 months of treatment,scores of behavioral pathology in Alzheimer's disease rating scale,brief psychiatric rating scale and neuropsychiatric questionnaire,Alzheimer disease assessment scale score and activity of daily living scale of the two groups all decreased,and were lower among the experimental groups(P<0.05).Compared with before treatment,there was no significant difference in electrocardiogram indexes between the two groups after 3 months of treatment(P>0.05).Compared with before treatment,after 3 months of treatment,the scores of mini-mental state examination and serum levels of norepinephrine dopamine and 5-hydroxytryptamine in the two groups increased,and those in the experimental group were higher(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(15.56%vs 20.00%,P>0.05).Conclusion Quetiapine combined with Memantine hydrochloride could control the BPSD of patients with AD,promote the recovery of cognitive function and improve the quality of life.The addition of drugs did not in

关 键 词：阿尔茨海默病 喹硫平 盐酸美金刚 精神行为症状 认知功能 神经递质 

分 类 号：R749.05[医药卫生—神经病学与精神病学]