奥氮平、喹硫平对阿尔茨海默病患者睡眠呼吸的影响

Effects of olanzapine and quetiapine on sleep-breathing in patients with Alzheimer' disease

目的观察并比较奥氮平、喹硫平对阿尔茨海默病(AD)患者睡眠呼吸功能的影响。方法伴有精神行为症状的AD患者随机分组,分别接受奥氮平(n=42)、喹硫平(n=38)治疗,疗程6周。治疗前、后行多导睡眠图检查,测定呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSa O2)、平均血氧饱和度(MSa O2)、血氧饱和度<90%时间占监测总时间的百分比(TS90%)。结果 1治疗后,奥氮平组AHI、TS90%增高(分别P<0.01、0.05),LSa O2、MSa O2降低(均P<0.05);喹硫平组变化不显著(P>0.05)。奥氮平组治疗后的AHI、TS90%显著高于喹硫平组(P<0.01),LSa O2、MSa O2显著低于喹硫平组(均P<0.05)。2治疗前,阻塞性睡眠呼吸暂停低通气综合征(OSAHS)发生率为27.5%(22/80);治疗后奥氮平组新出现的OSAHS患者比例高于喹硫平组(分别为6/31、0/27,P<0.05)。3治疗后,两组简易精神状态检查(MMSE)评分无显著变化(均P>0.05);而AD病理行为量表(BEHAVE-AD)评分显著降低(P<0.01)。两组治疗后的MMSE、BEHAVE-AD评分比较差异无统计学意义(P>0.05)。结论奥氮平对AD患者睡眠呼吸功能可能存在不良影响,而喹硫平的影响不显著。

Objective To study the effects of olanzapine and quetiapine therapeusis on sleep-breathing in patients with Alzhe-imer＆#39;disease （ AD） .Methods AD patients with psychological symptoms were randomly divided into groups that received olanzapine （n=42） and quetiapine （n=38） treatment for 6 weeks.Before treatment, underwent polysomnography examination , determination of apnea hypopnea index （AHI）, the lowest oxygen saturation （LSaO2）, the average oxygen saturation （MSaO2）, blood oxygen satura-tion monitoring 〈90%time percentage of total time （ TS90%） .Results ①After treatment , AHI and TS90%increased in olanzap-ine group （P〈0.01 and 0.05）, LSaO2, MSaO2 decreased （all P〈0.05）.The changes in quetiapine group was not significant （P〉0.05）.TS90%of Olanzapine group was significantly higher than that of quetiapine group （P〈0.01）.LSaO2 and MSaO2 were signifi-cantly lower than those of quetiapine group （both P〈0.05）.②Before pharmacon, 27.5%（22/80） AD subjects were diagnosed as obstructive sleep apnea hypopnea syndrome （OSAHS）.After pharmacon, more emerging OSAHS patients were surveyed in olanzapine group compared with that in quetiapine group （6/31 vs.0/27, P〈0.05）.③No significant change （both P〉0.05） in scores of min-i-mental state examination （MMSE） and a significant reduced score （both P〈0.01） of behavioral pathology in Alzheimer＆#39;disease rat-ing scale （ BEHAVE-AD） were found in both two groups at the end of study .There was no difference among the two groups with regard to score of MMSE or BEHAVE-AD after treatment （ both P〉0.05 ） .Conclusion Olanzapine therapeutics might do some harmful effects on sleep-breathing in patients with Alzheimer ＆#39;disease, while quetiapine therapeutics might do hardly any effects on that .