多奈哌齐治疗阿尔茨海默病患者认知功能的自然观察研究

Naturalistic observation of the effect of donepezil on cognitive function in Alzheimer＇s disease in memory clinic

目的 考察记忆门诊自然观察过程中多奈哌齐对阿尔茨海默病（AD）患者认知功能的改善作用。方法13例在记忆门诊就诊的符合NINCDS—ADRDA很可能AD诊断标准的接受多奈哌齐（5mg／d）治疗的轻中度AD患者纳入自然观察研究，采用认知功能筛查测验（CASI）评估患者认知功能，分别在治疗前、治疗3个月和6个月进行。结果与基线相比，治疗6个月时思维流畅性有显著改善（4．3±3．1与6．2±2．7，P〈0．05）；构图能力呈改善趋势，但差异无统计学意义（P=0．06），其余认知功能治疗前后比较差异均无统计学意义（P均〉0．05）。结论记忆门诊自然观察条件下，多奈哌齐能改善AD患者言语流畅性，并能使患者其他认知领域功能保持基本稳定。

Objective To examine the effect of donepezil on cognitive function of Alzheimer＇s disease from a naturalistic observation in memory clinic. Methods From the subject pool in memory clinic, thirteen patients with mild to moderate Alzheimer＇s disease （meeting NINCDS-ADRDA criteria of probable AD） were enrolled in the naturalistic observation. Donepezil with dosage of 5 mg daily was administered. Cognitive Ability Screening Instrument （CASI） was used to assess the cognitive function, and was administered at baseline ,3 and 6 months after treatment with donepezil. Results After 6-month treatment with donepezil, the change of score of verbal fluency from baseline was significant [ （4.3 ±3.1 ） vs （6.2 ±2.7） ,P 〈0.05]. There was a trend that constructional praxis was also improved after 6-month treatment （ P = 0.06 ）. The change of scores of other cognitive domains remained the same（ P 〉 0.05）. Conclusion In the naturalistic observation at memory clinic, donepezil may improve verbal fluency of AD patients, and keep most cognitive function stable.