卡巴拉汀与多奈哌齐治疗轻中度阿尔茨海默病患者的比较研究

Comparative study of rivastigmine and donepezil treatment in patients with mild to moderate Alzheimer disease

目的 比较卡巴拉汀和多奈哌齐治疗轻中度阿尔茨海默病 (AD)患者的疗效和安全性。方法 将 40例轻中度 AD患者随机均分为两组 ,用卡巴拉汀和多奈哌齐治疗 16周。采用简易精神状态量表 (MMSE)、Blessed-Roth量表和总体衰退量表 (GDS)评定疗效。安全性检查包括生命体征、实验室及心电图检查 ,每 4周 1次。结果 两组治疗前后 MMSE、GDS和 Blessed-Roth评分均有显著改善 (P<0 .0 5)。但两组治疗前后相关量表总分差值的 t检验均无显著意义 (P>0 .0 5)。两组治疗前后 Blessed-Roth各亚项分数差值比较无显著性 (P>0 .0 5) ,仅在社会活动能力方面卡巴拉组汀稍优于多奈哌齐组 (P>0 .0 5)。不良反应为胃肠道反应 ,发生率在 15.0 %～ 2 9.5%之间 ,以卡巴拉汀组多见。结论 卡巴拉汀和多奈哌齐可显著改善 AD患者的认知功能、痴呆程度和日常生活能力 ,疗效相当 ,较为安全 。

ObjectiveTo study on the efficacy and safety of rivastigmine and donepezil in patients with mild to moderate Alzheimer disease(AD). MethodsForty patients with mild to moderate AD were divided into two groups randomly and treated by rivastigmine and donepezil respectively. Mini Mental State Examination(MMSE),Bl essed Roth Rating Scale (BRRS) and Global Deterioration Scale(GDS) were taken to evaluated the efficacy . Vital signs,ECG and laboratorial tests were measured every 4 weeks for safety. ResultsThe scores of MMSE,GDS and BRRS in two groups were improved greatly( P < 0.05 ) but the difference of those scores between two groups at both baseline and end-point was not signi ficant( P > 0.05 ). The effect of rivastigmine in daily living and social activity slightly better t han that of donepezil( P > 0.05 ). Gastrointestinal tract reaction as adverse event was occurred between 13.6%～29. 5% and more commonly in rivastigmine treatment. ConclusionRivastigmine and donepezil both similarly improve cognition,dementia degree and daily living ability in AD patients with generally good toleration and safety.