不同剂量多奈哌齐对AD患者认知功能的干预作用研究

Intervention study of different doses of donepezil on cognitive function in patients with AD

目的观察不同剂量多奈哌齐对轻中度阿尔茨海默病（Alzheimer disease,AD）患者认知功能的改善情况,分析不同剂量多奈哌齐治疗轻中度AD患者的作用,为临床用药提供指导。方法选择2012年1月~2013年10月住院治疗的65例轻中度AD患者为研究对象,给予AD评分量表的简易智能精神状态量表（mini-mental state examination,MMSE）、认知分量表（alzheiner disease assessment scale-cognitives subscale,ADAS-cog）评分筛查后随机分为3组：2.5 mg组（22例）、5.0 mg组（22例）、10.0 mg组（21例）,分别给予多奈哌齐2.5 mg、5.0 mg、10.0 mg。2.5 mg组和5.0 mg组均睡前口服,1天1次;10.0 mg组初始剂量给予5.0 mg,睡前口服,1天1次,服用1个月后,改为10.0 mg,连续服用9个月。治疗后第3个月、6个月、9个月时分别收集3组患者的MMSE、ADAS-cog数据。结果治疗后MMSE评分：2.5 mg组较治疗前稍有提高,提高幅度无统计学意义,5.0 mg组和10.0 mg组较治疗前显著提高,差异有统计学意义（P〈0.05）,且10.0 mg组提高幅度明显大于5.0 mg组,2组差异有统计学意义（P〈0.05）。治疗后ADAS-cog评分：2.5 mg组较治疗前稍降低,降低幅度无统计学意义,5.0 mg组和10.0 mg组较治疗前显著降低,差异均有统计学意义（P〈0.05）,且10.0 mg组降低幅度明显大于5.0 mg组,差异有统计学意义（P〈0.05）。结论多奈哌齐对轻中度AD疗效可靠且存在剂量相关效应。

Objective To observe improvement of different doses of donepezil with mild-to-moderate Alzheimer＇s disease（ AD） patients on their cognitive function,and analysie the effect of different dosage of donepezil for the treatment of mild-to-moderate AD and provide guidance for clinical medication. Methods 65 cases of patients with mild-to-moderate AD were selected as the research objects from January 2012 to October 2013. The patients were divided into 3 groups after screened by the AD rating scale mental state（ MMSE） and the span of cognitive secondary scale（ ADAS-cog） ：2. 5 mg group（ 22 cases）,5. 0 mg group（ 22 cases） and 10. 0 mg group（ 21 cases）,which were given donepezil 2. 5 mg,5. 0 mg and 10. 0 mg,respectively. 2. 5 mg and 5. 0 mg group were given orally at bedtime,one times a day; 10. 0 mg group was given 5. 0 mg from the start,orally at bedtime,one times a day,taking after one month changed to 10. 0 mg. The whole treatment lasted for 9 months. MMSE,ADAS-cog data were collected respectively at the 3rd,6th and 9th months after treatment. Results MMSE score after treatment： 2. 5 mg group was slightly increased,there had no statistical significance. 5. 0 mg and 10. 0 mg group significantly increased（ P〈0. 05）,and 10. 0 mg increased significantly greater than 5. 0 mg group,the difference was statistically significant（ P〈0. 05）. ADAS-cog score after treatment： when compared with the previous period,the score in 2. 5 mg group slightly dropped,but there was no statistical significance. In 5. 0 mg and 10. 0 mg group,it decreased significantly（ P〈0. 05）,and the reduction of10. 0 mg group was obvious,the difference was statistically significant（ P〈0. 05）. Conclusion The curative effect of donepezil on mild-to-moderate AD is reliable,and there has a dose-related effect.