富马酸喹硫平联合多奈哌齐对阿尔茨海默病性痴呆的疗效及对血清生物标志物水平的影响  

Efficacy of quetiapine fumarate combined with donepezil in treatment of Alzheimer’s disease dementia and its impact on serum factor levels

作　　者：席杨 李海玲 Xi Yang;Li Hai-ling(The Second Department of Psychiatry,Xuzhou Dongfang Hospital,Xuzhou Medical University,Xuzhou 221004,China;Department of Substance Dependence,Xuzhou Dongfang Hospital,Xuzhou Medical University,Xuzhou 221004,China)

机构地区：[1]徐州医科大学附属徐州东方医院精神二科,徐州221004 [2]徐州医科大学附属徐州东方医院物质依赖科,徐州221004

出　　处：《中国药物应用与监测》2024年第6期729-733,共5页Chinese Journal of Drug Application and Monitoring

基　　金：江苏省老年健康科研项目(LKM2023034)。

摘　　要：目的探讨富马酸喹硫平联合多奈哌齐对阿尔茨海默病性痴呆的疗效,并分析其对患者血清生物标志物水平的影响。方法选取2023年1月至2023年9月徐州市东方人民医院就诊的80例轻中度阿尔茨海默病性痴呆患者,采用随机数字表法分为联合组和单药组,各40例。单药组患者给予盐酸多奈哌齐治疗,联合组患者在单药组基础上联合富马酸喹硫平治疗。评估并比较两组患者的简易智力状态检查量表(MMSE)和日常生活能力量表(ADL)评分、血清促炎性细胞因子(IL^(-1)β、IL-6、TNF-α)与三磷酸腺苷结合盒转运体7(ABCA7)、二胺氧化酶(DAO)及8-羟基脱氢鸟苷酸(8-OHdG)水平。结果治疗后,联合组患者的MMSE和ADL评分[分别为(20.92±2.44)分、(71.23±8.54)分]均高于单药组[分别为(19.73±2.15)分、(66.74±7.82)分](t=2.314、2.452,均P<0.05)。治疗后,联合组的IL^(-1)β、IL-6、TNF-α水平[分别为(5.71±1.52)pg·mL^(-1)、(6.71±2.23)pg·mL^(-1)、(4.24±1.13)pg·mL^(-1)]均低于单药组[分别为(6.93±1.76)pg·mL^(-1)、(9.04±3.08)pg·mL^(-1)、(5.47±1.28)pg·mL^(-1)](t=3.318、3.875、4.556,均P<0.05)。治疗后,联合组ABCA7、DAO、8-OHdG水平[分别为(1.22±0.12)μg·L^(-1)、(6.65±1.21)mg·L^(-1)、(3.75±0.43)ng·mL^(-1)]均低于单药组[分别为(1.41±0.13)μg·L^(-1)、(8.47±1.32)mg·L^(-1)、(4.32±0.62)ng·mL^(-1)](t=6.792、6.428、4.778,均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论富马酸喹硫平联合多奈哌齐可改善阿尔茨海默病性痴呆患者的认知功能和日常生活能力,降低其促炎性细胞因子水平和血清ABCA7、DAO、8-OHdG水平,且安全性良好。Objective To investigate the efficacy of quetiapine fumarate combined with donepezil in the treatment of Alzheimer’s disease dementia and its impact on patients’serum levels of related factors.Methods Eighty patients with mild-to-moderate Alzheimer’s disease admitted to Xuzhou Dongfang Hospital from January 2023 to September 2023 were selected and divided into the combination group and the monotherapy group by using the random number table method,with 40 in each group.The patients in the monotherapy group were treated with donepezil hydrochloride while those in the combination group with quetiapine fumarate on the basis of the regimen in the monotherapy group.The Brief Mental Status Examination(MMSE)and Ability to Perform Activities of Daily Living(ADL)scores,serum levels of pro-inflammatory factors(IL-1β,IL-6,TNF-α),adenosine triphosphate-binding cassette transporter 7(ABCA7),diamine oxidase(DAO)and 8-hydroxydehydroguanosine mononucleotide(8-OHdG)were determined and compared between the two groups.Results After treatment,the MMSE and ADL scores in the combination group((20.92±2.44)and(71.23±8.54))were higher than those in the monotherapy group((19.73±2.15)and(66.74±7.82))(t=2.314,2.452,both P<0.05).The levels of IL-1β,IL-6 and TNF-αin the combination group were lower than those in the montherapy group((5.71±1.52)pg·mL-1 vs(6.93±1.76)pg·mL-1,(6.71±2.23)pg·mL-1 vs(9.04±3.08)pg·mL-1,(4.24±1.13)pg·mL-1 vs(5.47±1.28)pg·mL-1)(t=3.318,3.875,4.556,all P<0.05).The ABCA7,DAO and 8-OHdG levels in the combination group((1.22±0.12)μg·L-1,(6.65±1.21)mg·mL-1 and(3.75±0.43)ng·mL-1)were lower than those in the monotherapy group((1.41±0.13)μg·L-1,(8.47±1.32)mg·mL-1 and(4.32±0.62)ng·mL-1)(t=6.792,6.428,4.778,all P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Quetiapine fumarate combined with donepezil can significantly improve cognitive function and daily living ability,reduce the levels

关 键 词：富马酸喹硫平 盐酸多奈哌齐 阿尔茨海默病性痴呆 三磷酸腺苷结合盒转运体7 二胺氧化酶 8-羟基脱氧鸟苷酸 

分 类 号：R749.16[医药卫生—神经病学与精神病学]