奥氮平联合卡巴拉汀对阿尔茨海默病精神行为症状、内环境指标的影响  

Effects of olanzapine combined with rivastigmine on mental and behavioral symptoms and internal environment indicators of patients with Alzheimer’s disease

作　　者：夏张倩 孙倩云 胡曼莉 胡建民 XIA Zhangqian;SUN Qianyun;HU Manli(Zhumadian Second People’s Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市第二人民医院,河南驻马店463000

出　　处：《精神医学杂志》2024年第3期281-285,共5页Journal of Psychiatry

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20210496)。

摘　　要：目的探讨奥氮平联合卡巴拉汀对阿尔茨海默病(AD)患者的治疗效果。方法将164例AD患者分为研究组和对照组,各82例。对照组给予卡巴拉汀治疗,研究组给予奥氮平联合卡巴拉汀治疗。采用简易精神状态检查量表(MMSE)、阿尔茨海默病评定量表(ADAS-cog)及蒙特利尔认知评估量表(MoCA)评估患者认知功能,采用神经精神科量表(NPI)、阿尔茨海默病病理行为评定量表(BEHAVE-AD)评估患者的精神行为症状,采用阿尔茨海默病日常生活能力量表(ADCS-ADL)、阿尔茨海默病生命质量测评量表(QoL-AD)评估患者的日常生活能力和生活质量。比较两组临床疗效、认知功能、精神行为症状、内环境指标、生存质量及不良反应。结果治疗后研究组总有效率高于对照组(P<0.05)。治疗后两组MMSE、MoCA评分均较治疗前升高(P<0.001),ADAS-cog评分均较治疗前降低(P<0.001);研究组治疗后MMSE、MoCA评分均高于对照组(P<0.001),ADAS-cog评分低于对照组(P<0.001)。治疗后两组NPI、BEHAVE-AD评分均较治疗前降低(P<0.001),研究组治疗后NPI、BEHAVE-AD评分均低于对照组(P<0.001)。治疗后两组低密度脂蛋白胆固醇(LDC-C)均较治疗前降低(P<0.05),三酰甘油(TG)、催乳激素水平均较治疗前升高(P<0.05),研究组治疗后TG、LDC-C及催乳激素水平均低于对照组(P<0.05)。治疗后两组ADCS-ADL、QoL-AD评分均较治疗前升高(P<0.05);研究组治疗后ADCS-ADL、QoL-AD评分均高于对照组(P<0.05)。两组总不良反应发生率比较差异无统计学意义(P<0.05)。结论奥氮平联合卡巴拉汀治疗AD可提高临床疗效,改善患者认知功能和精神行为症状,稳定内环境指标,提高生存质量,且安全可靠。Objective To explore the therapeutic effect of olanzapine combined with rivastigmine on patients with Alzheimer’s disease(AD).Methods A total of 164 patients with AD were randomly divided into control group and study group,with 82 cases in each group.The control group was treated with rivastigmine,and the study group was treated with olanzapine combined with rivastigmine.All subjects were assessed with Mini-Mental State Examination(MMSE),Alzheimer’s Disease Assessment Scale-Cognitive Section(ADAS-cog),Montreal Cognitive Assessment(MoCA),Neuropsychiatric Inventory(NPI),BEHAVE-AD,ADCS-ADL and QoL-AD.The clinical efficacy,cognitive function,psychological and behavioral symptoms,internal environment indicators,quality of life and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of study group was higher than that of control group(P<0.05).After treatment,the scores of MMSE and MoCA in both groups were higher than those before treatment(P<0.001),and the scores of ADAS-cog were lower than those before treatment(P<0.001).After treatment,the MMSE and MoCA scores of study group were higher than those of control group(P<0.001),and the ADAS-cog score was lower than that of control group(P<0.001).After treatment,the scores of NPI and BEHAVE-AD in both groups were lower than those before treatment(P<0.001),and the scores of NPI and BEHAVE-AD in study group were lower than those in control group(P<0.001).After treatment,the levels of low density lipoprotein cholesterol(LDC-C)in both groups decreased(P<0.05),and the levels of prolactin and triglyceride(TG)increased(P<0.05)compared with those before treatment.After treatment,the levels of TG,LDC-C and prolactin in study group were all lower than those in control group(P<0.05).After treatment,the scores of ADCS-ADL and QoL-AD in both groups were higher than those before treatment(P<0.05),and the scores of ADCS-ADL and QoL-AD in study group were higher than those in control group after treatment(P<0.05).There was no signifi

关 键 词：阿尔茨海默病 奥氮平 卡巴拉汀 疗效 认知功能 精神行为症状 内环境 生存质量 

分 类 号：R749.16[医药卫生—神经病学与精神病学]