伴发精神行为症状的高龄痴呆患者应用抗精神病药的安全性分析

Safety of antipsychotics use in the treatment of advanced age dementia patients with behavioral and psychological symptoms

目的:分析伴精神行为症状(BPSD)的高龄痴呆患者抗精神病药使用情况。方法:采用回顾性分析方法,根据是否应用抗精神病药治疗,将住院治疗的伴BPSD的80岁以上痴呆患者分为抗精神病药组(56例)和非抗精神病药组(34例),比较两组间安全性。结果:抗精神病药组中血管性痴呆患者的比例(32.1%)明显高于非抗精神病药组(8.8%)(χ^(2)=6.43,P<0.05);不同痴呆类型的患者间奥氮平、喹硫平、利培酮、阿立哌唑、氟哌啶醇的药物剂量比较,差异无统计学意义(P均>0.05)。不同痴呆类型间发生不良事件的比较,差异无统计学意义(P均>0.05)。结论:应用小剂量抗精神病药治疗伴有BPSD的高龄痴呆患者未升高不良事件发生的风险。

Objective:To investigate the safety of antipsychotics in aged dementia patients with behavioural and psychological symptoms(BPSD).Method:A retrospective cohort study was conducted to analyze dementia inpatients over 80 years old.According to whether or not having taken antipsychotic,dementia inpatients were divided into 2 groups:antipsychotic group(n=56)and non-antipsychotic group(n=34),and the safety of medication between the two groups was compared.Results:Compared to the non-antipsychotic group,the proportion of vascular dementia patients was significantly higher in the non-antipsychotic group(32.1%vs.8.8%,χ^(2)=6.43,P<0.05).There was no significant difference in the dosage of olanzapine,quetiapine,risperidone,aripiprazole and haloperidol among different types of dementia patients(all P>0.05).There was no significant difference in the adverse reactions between different types of dementia(all P>0.05).Conclusion:The low-dose of antipsychotics in aged dementia patients don't increase the risk of adverse reactions.