奥氮平、阿立哌唑对阿尔茨海默病患者睡眠呼吸功能的影响

Effects of Olanzapine and Aripiprazole on Sleep-breathing in Patients with Alzheimer' Disease

目的:对照研究奥氮平、阿立哌唑对阿尔茨海默病(AD)患者睡眠呼吸的影响。方法:AD伴精神行为症状患者随机接受6周的奥氮平(n=42)、阿立哌唑(n=36)治疗;采用多导睡眠图监测治疗前后睡眠呼吸功能的变化,观察指标包括呼吸暂停低通气指数(AHI)、平均血氧饱和度(MSaO2)、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6周时,奥氮平组AHI、TS90%较治疗前增高(t=3.101,2.613;P<0.01,0.05),MSaO2则有所降低(t=2.398,P<0.05);阿立哌唑组AHI、TS90%、MSaO2的变化均不显著(P>0.05);奥氮平组治疗后6周时的AHI、TS90%均高于阿立哌唑组(t=4.219,3.674;P均<0.001),MSaO2则低于阿立哌唑组(t=3.286,P<0.001);2治疗后6周时,两组简易精神状态检查(MMSE)评分均较治疗前无显著变化(P>0.05);AD病理行为量表(BEHAVE-AD)评分均显著下降(P<0.01);两组治疗后6周时的MMSE、BEHAVE-AD评分无显著差异(P>0.05)。结论:奥氮平对AD患者睡眠状态时的呼吸功能存在不良影响,阿立哌唑则影响甚微。

Objective：To explore the effects of olanzapine and aripiprazole on sleelo--breathing status in patients with Alzheimer＇disease（AD）.Methods： AD inpatients with behavioral and psychological symptoms were randomly di- vided into two groups, treated with olanzapine （n=42 ） or aripiprazole （n=36）. The patients were monitored with polysomnography（PSG）including the apnea hypopnea index （AHI）, the mean oxygen saturation （MSaO2）, and the total recorded time spent below 90% oxygen saturation（TS90%）detected pre and 6--weeks pro treatment.Results： After treatment,the level of AHI,TS90%（t=3.101,2.613;P〈0.01,0.05）were significantly increased and MSaO2 was significantly decreased（t=2.398, P=0. 05） in olanzapine group, but these parameters were not significantly changed in quetiapine group（P〉0.05）.There was a significant increased AHI, Ts90% （t= 4.219,3.674; both P〈0.001）or a significant decreased MSaO2（t=3.286,P〈0.001）in olanzapine group than that in quetiapine group al 6 weekend of the study.No significant change（P〉0.05）in scores of mini--mental state examination （MMSE）and a significant reduced score（t=3.019,2.811 ; both P〈0.01 ） of behavioral pathology in Alzheimer＇disease rating 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 may be harmful for sleep--breathing in AD patients,while quetiapine therapeutics may do hardly any effects on that.