喹硫平和奥氮平治疗老年痴呆精神行为症状比较研究.docVIP

喹硫平和奥氮平治疗老年痴呆精神行为症状比较研究 　　 摘要：目的：探讨喹硫平治疗老年痴呆的精神行为症状的疗效及安全性。方法： 60例老年痴呆患者随机分成两组，喹硫平组30例，奥氮平组30例，分别给予两药治疗12周。在治疗前及治疗后4周，8周，12周分别用阿尔茨海默病（AD）病理行为评定量表(AD.BEHAVE)评定疗效，药物不良反应采用不良反应量表(TESS)评定。结果：(1) 两组患者治疗前后BEHAVE-AD评分均显著下降(P0.05),但在攻击行为、行为紊乱2个因子的减分的差异具有显著性(P0.05)。(3) 喹硫平组不良反应较奥氮平组较少。结论：喹硫平与奥氮平对老年期痴呆患者伴发的精神行为症状均有效。喹硫平的优势在于对阿尔茨海默氏病的行为障碍的疗效更加明显并且对躯体状况的不良反应更少。 　　关键词：喹硫平；奥氮平；老年痴呆；精神行为症状Abstract:Objective:To investigate the effect and safety of quetiapine in treatment of the patients with senile dementia.Methods: In the 12-week randomly controlled trial, 60 patients with senile dementia were divided into two groups, 30 patients were treated with quetiapine, and another 30 patients were treated with olanzapine.The efficacy was assessed with the Behavioral Pathology in Alzheimer’s Disease Rating Scale(AD.BEHAVE), and side effects with the Treatment Emergent Symptoms Scale (TESS)at baseline and after 4,8,12-week treatment.Results: ①The BEHAVE-AD scores in both groups were significantly decreased after treatment(p 0.05), but there was a significant difference in aggressive behaviors and behavior disorder factors(P0.05);③Patients in quetiapine group experienced less side effects than Olanzapine group.Conclusion: Both quetiapine and olanzapine were effected in treating senile dementia.Quetiapinein was advantages in treating behavior disorders of senile dementia and has less physical side effect. 　　Key words:Quetiapine; Olanzapine ; Senile dementia; Behavioral and psychological symptoms 　　【中图分类号】R749.13【文献标识码】B【文章编号】1672-3783(2012)02-0010-02 　　阿尔茨海默病（Alzheimer disease，简称AD）是一种原因未明，主要侵犯大脑皮层神经元引起进行性痴呆的变性疾病。目前阿尔茨海默病的发病率日益增高，在美国等发达国家已成为继心脑血管疾病、恶性肿瘤之后的主要病死原因。我国人口老龄化程度的日益严重，张明园等在上海的调查发现65岁以上老年病人痴呆的患病率为4.69%[1]。患者除有认知功能障碍外，还会出现精神病性症状，如幻觉、妄想、抑郁、焦虑、行为紊乱等症状，1996年世界老年精神学会一致决定将痴呆的精神障碍统一称之为“痴呆行为和精神症状”（Behavioral and Psychological symptom of dementia, BPSD)[2]。BPSD的发生率为70%～90%。BPSD严重影响患者的日常生活能力及生活质量，给照料者带来巨大的心理、经济压力，是临床治疗的重点之一 。 　　本研究通过观察喹硫平与奥氮平治疗老年期痴呆精神行为症状的疗效，比较两种药物治疗痴呆患者BPSD的疗效和安全性，现报告如下。