奥氮平与喹硫平对伴精神行为症状老年痴呆患者糖脂代谢的影响

The effects of olanzapine and quetiapine on glucolipid metabolism of senile dementia patients with behavioral and psychological symptoms of dementia

目的 探讨奥氮平与喹硫平对伴精神行为症状老年痴呆患者糖脂代谢的影响.方法 将99例伴精神行为症状的老年痴呆患者按随机数字表法分为两组.研究组（49例）予以美金刚联合奥氮平治疗,对照组予以美金刚联合喹硫平治疗,观察12周.于治疗前后,采用痴呆病理行为量表、简易精神状态量表评定临床疗效,并检测糖脂代谢状况. 结果 治疗12周末,两组痴呆病理行为量表评分均较治疗前显著降低（P〈0.01）,简易精神状态量表评分较治疗前显著升高（P〈0.01）,两组比较差异无统计学意义（P〉0.05）.治疗12周末,两组体质量指数、总胆固醇、三酰甘油以及血糖水平均较治疗前显著升高（P〈0.01）,两组比较差异有统计学意义（P〈0.01）.结论 美金刚联合奥氮平或喹硫平治疗伴精神行为症状老年痴呆患者疗效显著且相当;但相较于喹硫平而言,奥氮平对糖脂代谢的影响更明显.

Objective To explore the effects of olanzapine and quetiapine on glucolipid metabolism of senile dementia patients with behavioral and psychological symptoms of dementia （BPSD）.Methods Ninety-nine senile dementia patients with BPSD were assigned to two groups according to random number table.Research group （n=49） received memantine plus olanzapine treatment and the control did memantine plus quetiapine for 12 weeks.Efficacies were assessed with the Behavioral Pathology in Alzheimer＇s Disease （BEHAVE-AD） and Mini-mental State Examination （MMSE） before and after treatment and glucolipid metabolism states detected.Results At the end of 12 week treatment the BEHAVE-AD scores of 2 groups lowered more significantly compared with pretreatment （P〈0.01） and the MMSE heightened （P〈0.01）, and group differences weren＇t significant （P〉0.05）.At the end of 12 week treatment BMI, cholesterol total, triacylglycerol and blood sugar levels of both groups heightened more significantly compared with pretreatment （P〈0.01） ad group differences significant （P〈0.01）.Conclusion Memantine combined with olanzapine or quetiapine has an evident effect in the treatment of senile dementia patients with BPSD and their efficacy are equivalent;olanzapine has more notable effect on glucolipid metabolism than quetiapine does.