哌罗匹隆与喹硫平治疗老年痴呆患者精神行为症状的对照研究

Control study on perospirone and quetiapine in the treatment of senile dementia patients with behavioral and psychological symptoms

目的:探讨哌罗匹隆治疗老年痴呆患者精神行为症状(BPSD)的临床疗效及安全性。方法:将106例老年痴呆患者随机分成哌罗匹隆组和喹硫平组,于治疗前及治疗后12周采用阿尔茨海默病病理行为评分表(BEHAVE-AD)、Cohen-Mansfied激越问卷(CMAI)、简易智力状态检查(MMSE)、日常生活能力评分(ADL)、不良反应量表(TESS)评价疗效及不良反应。结果:治疗12周后哌罗匹隆组有效率为82.0%,喹硫平组有效率为85.7%,两组差异无统计学意义(P>0.05)。哌罗匹隆治疗12周后BEHAVE-AD总分及各因子分均下降,其中在幻觉、行为紊乱、攻击行为3个因子的得分明显下降(P<0.01)。两组患者治疗12周后的MMSE及ADL评分均较治疗前有所增加,但治疗前后差异无统计学意义。哌罗匹隆的不良反应较喹硫平轻,但差异无统计学意义。结论:与喹硫平相比,哌罗匹隆治疗老年期痴呆精神行为障碍的疗效与安全性相当,不良反应较少。

ABSTRACT AIM： To compare the clinical effi- cacy and safety of perospirone and quetiapine in the treatment of senile dementia patients with behavioral and psychological symptoms. METH- ODS： 106 cases of senile dementia patients were randomly divided into the perospirone group and the quetiapine group. The efficacy and adverse reaction were evaluated by Behavioral Pathology in Alzheimer＇s Disease Rating Scale （BEHAVE- AD ）, Cohen-Mansfield Agitation Inventory （ CMAI ）, Mini-Mental State Examination （MMSE）, Activity of Daily Life （ADL） and Treatment Emergent Symptoms Scale （TESS） in baseline and after 12 weeks of treatment. RE- SULTS： After 12 weeks of treatment, the efficia- cy rate was 82.0% in perospirone group and 85.7% in quetiapine group. There were no sig nificant differences between the two groups （P 〉0.05）. The scores of BEHAVE-AD and other factors were significantly decreased after the 12 weeks of treatment with perospirone, especially factors of hallucinations, behavior disorders and aggressive behavior （P〈0.01）. The MMSE and ADL scores of two groups after the 12 weeks of treatment were higher than the scores before treatment, but there were no significant differ- ences between before and after treatment. The adverse reactions of perospirone group was lower than that of quetiapine group, but there were no significant differences between the two groups. CONCLUSION. Compared with quetiapine, per- ospirone has similar efficacy and safety in the treatment of behavioral and psychological symp- toms of senile dementia, and fewer adverse reac- tions were found in perospirone group.