盐酸多奈哌齐改善阿尔茨海默病患者认知功能及日常生活能力的效应(英文)

Effects of hydrochloric donepezil in improving cognition and daily life ability in patients with Alzheimer disease

背景:盐酸多奈哌齐治疗阿尔茨海默病(Alzheimerdisease,AD)受到临床关注,但其对认知功能及日常生活能力的改善是否有显著作用?目的:探讨盐酸多奈哌齐改善AD患者认知功能及日常生活能力的疗效,评价盐酸多奈哌齐治疗AD患者的有效性及安全性。设计:以诊断为依据的自身对照研究。地点和对象:1998-01/2001-03华中科技大学同济医学院附属梨园医院门诊和住院32例AD患者。干预:采用盐酸多奈哌齐5mg/d治疗16周。治疗前后用简易智能精神状态检查量表(MMSE)、阿尔茨海默病评定量表(theAlzheimerdiseaseassessmentscale,ADAS)及Blessed-RothScale痴呆量表评定患者认知功能及痴呆严重程度、精神行为异常和日常生活自理能力,并进行安全性评价。主要观察指标:①AD患者治疗前后MMSE,ADAS,Blessed-RothScale痴呆量表评分。②AD患者治疗期间不良反应。结果:盐酸多奈哌齐治疗后,患者MMSE评分较治疗前平均提高(4.1±1.1)分(P<0.01),ADAS认知部分改善(5.1±1.3)分(P<0.05);Blessed-Roth日常生活自理能力改善(1.2±0.5)分(P<0.05);ADAS的非认知行为部分减少(3.7±0.9)分,(P<0.05),2例(6%)出现轻度副作用。结论:盐酸多奈哌齐治疗AD有较好的疗效并安全性好,副作用小。

BACKGROUND:Hydrochloric donepezil is paid much attention in clinic on its therapeutic use of Alzheimer Disease(AD),but does it also play a significant role in improving cognition and daily life ability of AD patients?OBJECTIVE:To discuss the curative effect of hydrochloric donepezil in improving cognition and daily life ability of AD patients and also to assess its validity and security in AD therapy.DESIGN:Self-controlled study based on diagnosis.SETTING and PARTICIPANTS: Thirty-two AD in and out patients of Affiliated Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 1998 to March 2001 were involved into our study. INTERVENTION:Hydrochloric donepezil(5 mg per day) was used for 16 weeks.Before and after treatment,mini-mental state examination(MMSE),the Alzheimer disease assessment scale(ADAS) and Blessed-Roth Scale were used to assess cognition ability, degree of dementia,abnormity of psychological behavior and daily life ability of the patients. Security of hydrochloric donepezil was also valued.MAIN OUTCOME MEASURES:①score of MMSE,ADAS,Blessed-Roth Scale.②adverse reactions of the patients during treatment.RESULTS:After treatment the score of MMSE was increased 4.1±1.1 averagely(P< 0.01), that of cognition part of ADAS was improved 5.1 ±1.3(P< 0.05),that of Blessed-Roth daily life ability was improved 1.2±0.5(P< 0.05),and that of Non-cognition part of ADAS was decreased 3.7±0.9(P< 0.05),and slight side effects occurred in 2 patients(6%).CONCLUSION:Hydrochloric donepezil has good therapeutic effect and security and without obvious side effect in AD therapy.