盐酸美金刚治疗老年认知功能障碍患者的疗效观察

Observation of the effect of memantine on elderly patients with cognitive dysfunction

目的:探讨盐酸美金刚在改善老年认知功能障碍患者中的疗效。方法:对2017年1月至2018年12月就诊于贵州医科大学附属医院老年医学科的老年认知功能障碍患者进行回顾性研究,病例数为114例。按照药物治疗方案分为3组:①多奈哌齐组;②多奈哌齐加美金刚组;③多奈哌齐加美金刚再加奥拉西坦组。在初诊、治疗1个月.3个月时对3组患者行简易智能精神状态检查量表(MMSE)评分、神经精神科问卷(NPI)评分测定,主要照料者行Zarit照顾负担量表(ZBI)评分情况统计,比较3组患者的临床治疗效果。结果:初诊时3组的MMSE评分.NPI评分.照料者ZBI评分组间比较差异无统计学意义,治疗1个月,3个月时②组.③组的MMSE评分高于①组(P<0.05),NPI评分低于①组(P<0.05);ZBI评分低于①组(P<0.05)。各组在治疗1个月时MMSE评分明显高于初诊时(P<0.05),NPI评分低于初诊时(P<0.05),ZBI评分低于初诊时(P<0.05);治疗3个月时MMSE评分高于治疗1个月时(P<0.05),NPI评分低于治疗1个月时(P<0.05),ZBI评分低于治疗1个月时(P<0.05)。而②组.③组在治疗1个月.治疗3个月时MMSE评分.NPI评分比较差异无统计学意义(P>0.05)。结论:多奈哌齐加盐酸美金刚、多奈哌齐加盐酸美金刚再加奥拉西坦均可改善患者的认知功能障碍及精神症状,但两组比较差异无统计学意义,说明盐酸美金刚在改善患者的精神神经症状方面起主要作用。

Objective:To investigate the efficacy of Memantine in the treatment of cognitive impairment in the elderly people.Methods:114 old patients with cognitive impairment treated in the Department of Geriatrics,Affiliated Hospital of Guizhou Medical University from January 2017 to December 2018 were studied retrospectively.According to the pharmaceutic treatment plan.the cases were divided into three groups randomly:Donepezil group(Group 1),Donepizil plus Memantine group(Group 2)and Donepizi plus Memantine and Oxiracetam group(Group 3).At the initial diagnosis.1 month and 3 months after treatment.the scores of Minimental state Examination(MMSE),Neuropsychiatri inventory(NPI)scores.and Zarit caregiver Burden Interview(ZBI)of the 3 groups were detected and the curative effects of the 3 kinds of treatment were compared.Results:There was no.significant difference in MMSE.NPI and ZBI scores of the 3 groups at the first diagnosis.One month and 3 months after treatment,MMSE scores of Group 2 and 3 were higher than those of Group 1(P<0.05),while their NPI scores were lower than those of Group 1.The scores of ZBI of Groups 2 and 3 were lower than those of Group 1 in one month and 3 months after treatment.MMSE scores of each group 3 months after treatment were significantly higher than those in 1 month after treatment(P<0.05),and NPI was lower than that 1 month after treatment,and the scores of MMSE 3 months after:treatment were higher than those 1 month after treatment(P<0.05),while NPI and ZB1 scores were lower than those 1 month after treatment(P<0.05).There was no significant difference in MMSE and NPI scores between Groups 2 and 3 in one month and 3 months after treatment(P>0.05).Conclusion:Donepezil plus Memantine group and Donepezil plus Memantine and Oxiracetam group can not only reduce the cognitive impairment of patients,but also their mental and behavioral abnormalities after cognitive impairment.There was no significant difference between the two methods of treatment.Memantine plays a major role in the treatment of psychoneurotic symptoms of patients.