AD治疗全球指南.pptxVIP

AD治疗全球指南会计学AD治疗指南第1页/共32页美国神经病学会(AAN)指南-2001美国精神病学学会(APA)指南2007美国内科医师学会(ACP) 美国家庭医师学会(AAMP)指南-2008英国NICE指南-2007中国防治认知功能障碍专家共识-2006美国老年精神医学学会指南-2006英国精神药理学会(BAP)抗痴呆药物指南-2006加拿大痴呆诊治指南-2008第2页/共32页美国AAN指南-2001数据来源－第3页/共32页美国AAN指南-2001第4页/共32页Pharmacologic treatment of AD Practice recommendationsCholinesterase inhibitors should be considered in patients with mild to moderate AD (Standard), although studies suggest a small average degree ofbenefit.Vitamin E (1000 I.U. PO BID) should be considered in an attempt to slow progression of AD (Guideline).Selegiline (5 mg PO BID) is supported by one study, but has a less favorable risk–benefit ratio (Practice Option).There is insufficient evidence to support the use of other antioxidants, anti-inflammatories, or other putative disease-modifying agents specifically to treat AD because of the risk of significant side effects in the absence of demonstrated benefits (Practice Option).Estrogen should not be prescribed to treat AD (Standard).Some patients with unspecified dementia may benefit from ginkgo biloba, but evidence-based efficacy data are lacking (Practice Option). 第5页/共32页美国精神病学会(APA)指南2007数据来源1994－2004年第6页/共32页LEVELS of RECOMMENDATION[I] Recommended with substantial clinical confidence[II] Recommended with moderate clinical confidence[III] May be recommended on the basis of individual circumstances第7页/共32页Treatment of Cognitive SymptomsCholinesterase inhibitorsshould be offered to patients with mild to moderate Alzheimer’s disease after a thorough discussion of their potential risks and benefits [I]may behelpful for patients with severe Alzheimer’s disease [II].should be considered for patients with mild to moderate dementia associated with Parkinson’s disease [I].can be considered for patientswith dementia with Lewy bodies [II].第8页/共32页Treatment of Cognitive SymptomsMemantinemay provide modest benefits and has few adverse effects; thus, it may be considered for moderate and severe AD patients [I].There is some evidence