美金刚联合多奈哌齐治疗老年中重度阿尔茨海默病患者的临床疗效

Clinical efficacy of memantine combined with donepezil in the treatment of elderly patients with moderate to severe Alzheimer's disease

目的探讨美金刚联合多奈哌齐治疗老年中重度阿尔茨海默病(AD)患者的临床疗效。方法选取2018年12月至2019年12月于本院就诊的88例中重度阿尔茨海默症患者作为研究对象,采用掷硬币法分为观察组和对照组,各44例。对照组单一使用多奈哌齐治疗,观察组在对照组基础上联合美金刚治疗,比较两组患者治疗前后简易智力状态检查量表(MMSE)评分、日常生活能力量表(ADL)评分、神经精神科问卷(NPI)评分、蒙特利尔认知评估量表(MoCA)评分、氧化应激指标、血管内皮功能指标及不良反应发生情况。结果治疗6个月后,观察组MMSE评分高于对照组(P<0.05)。治疗6个月后,观察组ADL、MoCA评分均高于对照组,NPI评分低于对照组(P<0.05)。治疗6个月后,观察组丙二醛(MDA)、β淀粉样蛋白(Aβ)水平均低于对照组,超氧化物歧化酶(SOD)水平高于对照组(P<0.05)。治疗6个月后,观察组血管内皮生长因子(VEGF)、一氧化氮(NO)水平均高于对照组(P<0.05)。观察组不良反应发生率为11.36%,对照组为9.09%,两组不良反应发生率比较差异无统计学意义。结论与单独使用多奈哌齐比较,美金刚联合多奈哌齐临床疗效更佳,能有效改善患者病情,提高自主生活能力,改善患者痴呆精神行为症状及认知功能,还可改善患者氧化应激反应及血管内皮功能,安全可靠。

Objective To explore the clinical efficacy of memantine combined with donepezil in the treatment of elderly patients with moderate to severe Alzheimer's disease(AD).Methods A total of 88 patients with moderate to severe AD treated in our hospital from December 2018 and De-cember 2019 were selected as the research subjects,and they were divided into observation group and control group according to coin tossing meth-od,with 44 cases in each group.The control group was treated with donepezil,while the observation group was treated with memantine on the basis of the control group.The scores of mini-mental state examination(MMSE),activity of daily living(ADL)scale,neuropsychiatric inventory(NPI)and montreal cognitive assessment(MoCA),oxidative stress indexes,vascular endothelial function indexes before and after treatment,and the occur-rence of adverse reactions were compared between the two groups.Results After 6 months of treatment,MMSE scores in the observation group was higher than that in the control group(P<0.05).After 6 months of treatment,ADL and MoCA scores in the observation group were higher than those in the control group,NPI score was lower than that in the control group(P<0.05).After 6 months of treatment,malonic dialdehyde(MDA)andβamyloid protein(Aβ)levels in the observation group were lower than those in the control group,while superoxide dismutase(SOD)level was higher than that in the control group(P<0.05).After 6 months of treatment,vascular endothelial growth factor(VEGF)and nitric oxide(NO)levels in the observation group were higher than those in the control group(P<0.05).The incidence of adverse reactions was 11.36%in the observation group,and 9.09%in the control group,there was no significant difference between the two groups.Conclusion Compared with donepezil alone,meman-tine combined with donepezil has better clinical efficacy,which can effectively improve conditions,the ability of independent living,neuropsychiat-ric symptoms,cognitive function,oxidative stress response and vascular endothelial function of patients,which is safe and reliable.