阿立哌唑联合奥氮平治疗老年阿尔茨海默病伴精神障碍的临床疗效及安全性评价

Clinical efficacy and safety of aripiprazole combined with olanzapine in the treatment of elderly Alzheimer's disease with mental disorders

目的观察阿立哌唑联合奥氮平治疗老年阿尔茨海默病伴精神障碍的临床疗效及安全性。方法将80例老年阿尔茨海默病伴精神障碍患者随机分为对照组40例和试验组40例。对照组予以口服奥氮平2.5 mg,每晚一次;试验组予以口服奥氮平2.5 mg,每晚一次联合阿立哌唑2.5 mg,每晚一次。2组患者一个疗程均为2周,共治疗4个疗程。比较2组患者的临床疗效、简易智能精神状态表(MMSE)评分、临床失智表(CDR)评分、日常生活能力表(ADL)评分、阿尔茨海默病评价表-认知分量表(ADAS-cog)评分、精神神经科问卷(NPI)评分、激动性问卷(CMAI)评分,以及不良反应发生率。结果治疗后,试验组的总有效率97.50%显著高于对照组47.50%(P<0.05)。治疗后,试验组的MMSE评分显著高于对照组(P<0.05),试验组的CDR、ADL、ADAS-cog、NPI、CMAI的评分显著低于对照组(P<0.05)。试验组的不良反应发生率7.50%显著低于对照组40.00%(P<0.05)。结论阿立哌唑联合奥氮平治疗老年阿尔茨海默病伴精神障碍的临床疗效确切,有利于患者神经功能的恢复,且不良反应较小。

Objective To evaluate the clinical efficacy and safety of aripiprazole combined with olanzapine in the treatment of elderly Alzheimer＇s disease with mental disorders. Methods Eighty patients of elderly Alzheimer＇s disease with mental disorders were randomly divided into treatment group（ n = 40） and control group（ n = 40）. Patients in control group were received olanzapine 2. 5 mg,oral,qn. Patients in treatment group were given olanzapine 2. 5 mg,oral,qn and aripiprazole 2. 5 mg,oral,qn. The course of treatment was 2 weeks in two groups. A total of treatment was 4 courses. They were compared with clinical efficacy,easy- mental state table（ MMSE） score,clinical dementia table（ CDR）score,table of daily living（ ADL） score,Alzheimer＇s disease assessment form- cognitive subscale（ ADAS- cog） score,spirit of neurology questionnaire（ NPI） score,agonistic questionnaire（ CMAI） score,and the incidence of adverse drug reactions. Results After treatment,the total efficiency of the treatment group was significantly higher than that of control group（ 97. 50% vs 47. 50%,P〈0. 05）. MMSE score of the treatment group was significantly higher than that of control group（ P〈0. 05）. CDR,ADL, ADAS- cog, NPI, CMAI score of thetreatment group was significantly lower than that of control group（ P〈0. 05）. The incidence of adverse drug reactions of the treatment group was significantly lower than that of control group（ 7. 50% vs 40. 00%, P〈0. 05）.Conclusion Aripiprazole combined with olanzapine has a definitive clinical efficacy for the treatment of elderly Alzheimer＇s disease with the exact mental disorders,which can help the recovery neurological function with less adverse drug reactions.