富马酸喹硫平治疗阿尔茨海默病精神行为症状48例

Effects of Quetiapine Fumarate on Psychological and Behavioral Symptoms of 48 Cases of Patients with Alzheimer's Disease

目的探讨富马酸喹硫平治疗阿尔茨海默病(AD)患者精神行为症状疗效与安全性。方法 AD患者74例,随机分为治疗组48例和对照组26例。对照组给予盐酸多奈哌齐,起始剂量5 mg,每天1次,连续治疗12周。治疗组在对照组治疗基础上,给予富马酸喹硫平,起始剂量12.5 mg,每天1次。分别于治疗前(基线),治疗1,2,4,8和12周末采用简易精神状态检查量表(MMSE)、简明精神病评定量表(BPRS)、神经精神科问卷(NPI)、NPI苦恼因子和日常生活能力量表(ADL)进行评估。结果治疗1周,治疗组与对照组的NPI总分分别为(72.830±10.45)和(78.057±10.97)分,NPI苦恼因子分别为(30.532±5.82)和(34.208±6.50)分(P<0.05);治疗2周,治疗组与对照组NPI总分分别为(65.723±9.98)和(70.714±10.33)分,NPI苦恼因子分别为(29.177±6.52)和(32.567±7.44)分(P<0.05);治疗4周,治疗组与对照组BPRS评分分别为(30.277±6.43)和(35.01±7.38)分(P<0.05);治疗8周,治疗组与对照组NPI苦恼因子分别为(23.021±5.74)和(28.618±6.080)分(P<0.01)。治疗12周,治疗组和对照组MMSE分别为(7.83±3.02)和(7.116±2.67)分,较治疗前均有升高(P>0.05)。结论短期使用富马酸喹硫平治疗可降低AD照料者的苦恼,减轻AD患者精神行为症状,可能对认知功能产生有利影响。

Objective To study clinical application and safety of quetiapine fumarate in treating Alzheimer’s disease(AD).Methods A total of 74 patients with AD were randomly divided into treatment group(n=48)and control group(n=26).Patients in the control group were given 5 mg·d-1 of donepezil chloride,patients in the treatment group were given 5 mg·d-1 of donepezil chloride and 12.5 mg·d-1 of quetiapine fumarate.Before and 1,2,4,8 and 12 weeks after the treatment,the patients were evaluated by mini-mental state examination(MMSE),the brief psychiatric rating scale(BPRS),neuropsychiatric inventory(NPI),NPI distress factor and activity of daily life(ADL).Results After 1 week of treatment,total NPI score of treatment group and control group was(72.830±10.45)and(78.057±10.97),respectively;NPI distress factor was(30.532±5.82)and(34.208±6.50),respectively(all P<0.05).After 4 weeks of treatment,BPRS scores of treatment group and control group was(30.277±6.43)and(35.01±7.38),respectively(P<0.05).After 8 weeks of treatment,NPI distress factor of treatment group and control group was(23.021±5.74)and(28.618±6.08)(P<0.05).After 12 weeks,MMSE score of treatment group and control group was(7.83±3.02)and(7.116±2.67),which was increased compared with that before treatment(all P>0.05).Conclusion Short-term use of quetiapine fumarate can reduce anguish of AD tender,and relieve psychological and behavioral symptoms of AD patients,and may have positive effects on cognitive function.