阿立哌唑对老年阿尔茨海默病合并精神病性障碍患者疗效及不良反应的观察

Effect of aripiprazole on the scores of psychiatric symptoms in elderly patients with Alzheimer's disease complicated with mental disorders

目的研究阿立哌唑对老年阿尔茨海默病合并精神障碍患者各精神症状量表评分的影响。方法研究对象选取我院2016年1月～2017年3月间收治的老年阿尔茨海默病合并精神障碍患者128例,采用随机数字法将其分为对照组和观察组,每组各64例。对照组患者接受奋乃静治疗,观察组患者接受阿立哌唑治疗。比较两组患者治疗前后阿尔茨海默病病理行为评定量表(BEHAV-AD)、社会功能评定量表(PSP)及治疗后副反应量表(TESS)评分。结果治疗后2、4、6、8周,观察组患者的BEHAV-AD总评分均明显低于对照组(P<0.01),观察组在偏执和妄想、幻觉、攻击、活动异常、昼夜节律紊乱、情感障碍各方面BEHAV-AD评分均明显低于对照组(P<0.05)。治疗后2、4、6、8周,观察组的PSP总评分均显著高于对照组(P<0.01)。治疗后8周,观察组的TESS评分为(6.88±1.36),明显低于对照组(8.78±2.13)(t=5.36,P=0.00)。结论阿立哌唑能更好治疗患者阳性、阴性精神异常症状,提高患者生活质量和社交能力,且治疗安全性较高,值得在临床推广。

Objective To study the effect of aripiprazole on psychiatric symptoms in elderly patients with Alzheimer’s disease. Methods 128 cases of elderly patients with Alzheimer’s disease complicated with mental disorders were selected from January 2016 to March 2017 in our hospital. They were randomly divided into control group and observation group,with 64 cases in each group. The control group received perphenazine treatment,and the observation group received aripiprazole treatment. BEHAV-AD,PSP and TESS score were compared between the two groups before and after treatment. Results At 2,4,6,8 weeks after treatment,the total scores of BEHAV-AD in the observation group were significantly lower than those in the control group(P<0.01),the scores of BEHAV-AD in the aspects of paranoia,delusion,hallucination,attack,abnormal activity,circadian rhythm disorder,emotional disorder in the observation group were lower than those in the control group(P<0.05). At 2,4,6,8 weeks after treatment,the total score of PSP in the observation group was significantly higher than that in the control group(P<0.01). At 8 weeks after treatment,the score of TESS in the observation group was(6.88 + 1.36),which was significantly lower than that of the control group(8.78 + 2.13)(t=5.36,P=0.00). Conclusion Aripiprazole has better effect on Alzheimer’s patients with positive and negative mental abnormalities,can improve the quality of life and social ability of patients,and the treatment of high safety,less adverse reaction of the vertebral body.