比较奥氮平与喹硫平对阿尔茨海默病患者睡眠呼吸功能的影响

Quetiapine on the Sleep Respiratory Function of Patients with Alzheimer Disease

目的分析比较阿尔茨海默病患者,使用奥氮平和喹硫平后对患者睡眠呼吸功能的影响。方法方便选取该院2014年1月—2015年12月收治的阿尔茨海默病患者80例,随机分成两组,每组40例。第一组使用奥氮平进行治疗,治疗疗程为8周,第二组使用喹硫平进行治疗,治疗疗程为8周。在阿尔茨海默病患者治疗前和治疗后进行多导睡眠图检查,对阿尔茨海默病患者的睡眠呼吸功能进行检测。检测阿尔茨海默病患者的平均血氧饱和度、最低血氧饱和度、血氧饱和度<90%时间占总监测时间的比例以及患者呼吸暂停低通气指数,对比奥氮平和喹硫平对阿尔茨海默病患者睡眠呼吸功能的影响。结果第一组患者使用奥氮平治疗后,血氧饱和度<90%时间占总监测时间的比例为(13.3±4.8)%,对比治疗前有明显增高(9.1±4.2)%,并且高于第二组使用喹硫平的患者(9.8±4.5)%。第一组的呼吸暂停低通气指数也有增高(13.5±5.1)次/h,并且明显高于第二组的呼吸暂停低通气指数(9.1±4.3)次/h。第一组的最低血氧饱和度(78.1±8.1)%和平均血氧饱和度(91.2±4.5)%有所降低,并且明显低于第二组患者(83.2±9.4)%、(95.0±3.8)%。两组对比差异有统计学意义(P<0.05)。阿尔茨海默病患者在治疗前,阻塞性睡眠呼吸暂停低通气综合征的发病率是27.8%,患者治疗后,第一组出现这种症状的比例比第二组高,两组患者的阿尔茨海默病病理行为量表有明显的降低,简易精神状态检查没有明显变化。结论阿尔茨海默病患者使用奥氮平可能对睡眠呼吸功能有不良影响,使用喹硫平影响不明显。

Objective To analyze th e effect of Olanz ap in e and q u e t ia p in e on th e s leep resp irato ry fu n ction of p a t ien ts with Alzheimer d is e a s e. Methods 80 c a se s of p a t ien ts with Alzhe imer d ise a s e adm it ted an d tre a ted in our h ospi tal from Jan ua ry 2014 to Dec emb er 2015 were co n venien t se le c ted an d randomly d iv id ed into two groups with 40 c a se s in e a c h , th e first group were tre a ted with Olanz ap in e for eigh t w eeks, whi le th e second group were tre a ted with q u e t ia p in e for eigh t w eeks, and the p a t ien ts with Alzhe imer d ise a s e before and af te r tre a tm en t were examined by th e polysomnogram, and th e s leep re s-piratory fu n ction of p a t ien ts with Alzheimer d ise a s e was te s te d , an d th e average oxygen sa tu ra t io n of blood, lowest oxygen saturat ion of blood, ratio of time of oxygen satu ra tio n of blood less th an 9 0 % in th e to ta l monitoring time and a p n e a h y-poventi lat ion in d ex of p a t ien ts were te s te d , an d th e effect of O lanz ap in e an d q u e t ia p in e on th e s leep re sp irato ry fu n ction of pat ients with Alzhe imer d ise a s e was com p a red. Results After tre a tm en t, th e ratio of time of oxygen satu ra tio n of blood less than 90% in th e to ta l monitoring time in th e firs t group was h ig he r th an th a t in th e second gro up[（13.3±4.8）% vs （9.8±4.5）%], and the a p n e a hyp ov enti la tio n in d ex of p a t ien ts in th e first group was obviously h ig he r th an th a t in th e second group （13.5土5.1）times /h vs （9.1±4.3）times/ h,th e lowest oxygen satu ra tio n of blood an d average oxygen sa tu ra t io n of blood in th e first group were obviously lower th an th o se in th e second g ro up, [（78.1±8.1）%,（91.2±4.5）% vs （83.2±9.4）%,（95.0±3.8）%],an d the differences b etwe en th e two groups had s ta t is t ic a l sign if ic an ce by comparison （ P 〈0.05）, before tre a tm en t, th e in c id e n c e ra te of obstruct ive s leep ap n e a h yp op n ea syndrome was 27.8%, af te r tre a tm en t, th e ratio of th e symptom was h ig h e r th an th a t in the second g ro up, an d th e Alzheimer p a th o lo gical beh av io r sca le of th e two groups d e c re a se d obviously, and th e Mini - Mental State Examin ation h ad no obvious ch a n g e. Conclusion The use of Olanz ap in e for p a t ien ts with Alzhe imer d ise a se may have no ad v erse effect on th e s leep re sp ira to ry fu n ction and th e effect of q u e t ia p in e is not obvious.