盐酸美金刚联合奥氮平治疗>90岁阿尔茨海默病伴精神行为症状患者效果及安全性分析

The Analysis about Effects and Safety of Memantine Hydrochloride Combined with Olanzapine in Treating Alzheimer’s Disease with Behavioral and Psychological Symptoms for Patients Aged Over 90

目的:观察分析盐酸美金刚联合奥氮平治疗>90岁阿尔茨海默病(AD)伴精神行为症状(BPSD)患者的效果及安全性。方法:选取2016年1月-2020年12月辽宁省金秋医院收治的>90岁AD伴BPSD患者120例作为研究对象,采取随机数字表法,将其分为观察组及对照组,每组60例。观察组给予盐酸美金刚联合奥氮平治疗,对照组仅给予盐酸美金刚治疗,比较两组的简易精神状态量表(MMSE)、AD病理行为评分量表(BEHAVE-AD)及日常生活能力量表(ADL)评分、治疗BPSD的效果及不良反应。结果:重复测量方差分析结果显示,不同组别及不同时间点MMSE、BEHAVE-AD及ADL评分等指标差异有统计学意义(P<0.05),组别因素与时间效应的交互作用差异无统计学意义(P>0.05)。观察组治疗4周时BEHAVE-AD评分低于对照组,治疗12、24周时BEHAVE-AD、ADL评分低于对照组,MMSE评分高于对照组,观察组治疗精神行为症状疗效高于对照组,差异均有统计学意义(P<0.05)。观察组嗜睡发生率高于对照组,差异有统计学意义(P<0.05)。结论:对>90岁AD伴BPSD患者应用盐酸美金刚联合奥氮平治疗能够明显减轻精神行为症状,改善认知功能及生活能力,不良反应少。

Objective:To investigate the effects and safety of Memantine Hydrochloride combined with Olanzapine in treating Alzheimer’s disease(AD)with behavioral and psychological symptoms of dementia(BPSD)for patients aged over 90.Method:From January 2016 to December 2020,120 inpatients aged over 90 with AD complicated with BPSD who were hospitalized in Jinqiu Hospital of Liaoning Province were enrolled in this study.By random number table all the patients were divided into the observation group(n=60)and the control group(n=60).The observation group was treated with Memantine Hydrochloride combined with Olanzapine,and the control group was treated with Memantine Hydrochloride.The mini mental state examination(MMSE),behavioral pathology in Alzheimer’s disease rating scale(BEHAVE-AD)and activity of daily living(ADL)scores,the effect in AD patients with BPSD and adverse reactions were observed between the two groups.Result:Repeated anova showed that there were significant differences in MMSE,BEHAVE-AD and ADL scores between different groups and different times(P<0.05),and there was no significant difference in interaction effects between time and group(P>0.05).On 4th week,BEHAVE-AD score in the observation group was lower than that of the control group,and on 12th week and 24th week,BEHAVE-AD and ADL scores in the observation group were lower than those in the control group,and MMSE scores were higher than those in the control group,and there were significant differences(P<0.05).In observation group treatment effective rate of BPSD was obviously higher than that of the control group,and the incident rate of hypersomnia was higher than the control group,the differences were statistically significant(P<0.05).Conclusion:For the patients aged over 90 with AD complicated with BPSD,the Memantine Hydrochloride combined with Olanzapine can remarkably improve BPSD,cognitive impairment and daily living ability,and has fewer adverse reaction.