奥氮平和喹硫平治疗老年期痴呆患者精神行为症状的对比分析

Comparative analysis of treatment with Olanzapine and Quetiapine on behavioral and psychological symptoms of patients with Alzheimer's

目的探讨奥氮平和喹硫平治疗老年期痴呆患者精神行为症状的临床疗效与不良反应。方法将我院收治的120例老年期痴呆患者随机分为奥氮平组与喹硫平组,每组60例,奥氮平组使用奥氮平,初始剂量2.5 mg/d,4周内逐渐增至5~15 mg/d;喹硫平组应用喹硫平,初始剂量25 mg/d,4周内逐渐增至200~400 mg/d。比较2组患者治疗前后的BEHAVE-AD、MMSE。结果 2组患者治疗后BEHAVE-AD、MMSE及ADL评分均较治疗前明显改善（P〈0.01）,但治疗后2组比较无统计学差异（P〉0.05）;2组患者的嗜睡、头晕、便秘、震颤、静坐不能、直立性低血压、失眠比较无统计学差异（P〉0.05）,奥氮平组患者的口干、体重增加、锥体外系反应明显多于喹硫平组,2组比较差异显著（P〈0.01）。结论奥氮平和喹硫平治疗老年期痴呆患者均能取得满意疗效,且不良反应少,值得临床推广应用。

Objective To investigate the clinical efficacy and adverse reactions of treatment with olanzapine and quetiapine on behavioral and psychological symptoms of patients with Alzheimer＇s.Methods We divided 120 patients with Alzheimer＇s who were hospitalized in our hospital randomly into the Olanzapine Group and Quetiapine group, 60 for each group. The Olanzapine Group was treated with Olanzapine,with an initial dose of 2.5 mg/d,gradually increased to5-15 mg/d within 4 weeks;while the Quetiapine Group was treated with Quetiapine, with an initial dose of 25 mg/d, gradually increased to 200-400 mg/d within 4 weeks. The BEHAVE-AD MMSE ratings of both of groups of patients before and after treatment were compared. Results After treatment, the BEHAVE-AD, MMSE and ADL ratings f both of groups of patients were significantly improved compared with that before treatment （P〈0.01）,but there was no significant difference between the two groups after treatment（P〉0.05 ） ; there was no significant difference in somnolence, dizziness, constipation, tremor, akathisia, orthostatic hypotension and between the two groups （P〉0.05）;the dry mouth, weight gain and extrapyramidal reactions of the patients of Olanzapine Group were significantly more that of the Quetiapine Group, there was significant difference between the two groups （P〈0.01）.Conclusions Both of Olanzapine and quetiapine can achieve satisfactory results on treatment for patients with Alzheimer＇s, with fewer adverse reactions, therefore they are worthy of clinical application.