摘要
目的分析盐酸多奈哌齐联合美金刚对阿尔茨海默病(AD)患者认知功能的影响。方法选取枣庄市精神卫生中心2021年1月至2023年3月治疗的AD患者90例进行随机对照研究,采用随机数字表法将患者分为多奈哌齐组、联合组各45例。多奈哌齐组口服盐酸多奈哌齐片,联合组口服盐酸多奈哌齐片和口服美金刚片,两组连续治疗12周。比较两组治疗前后日常生活能力量表(ADL)、AD行为病理评定量表(BEHAVE-AD)、简易精神状态量表(MMSE)评分及生化指标[同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)及中枢神经特异性蛋白S100(S100β)]的变化。观察两组药物不良反应发生情况。结果治疗后,联合组ADL、BEHAVE-AD、MMSE评分分别为(78.9±6.1)分、(5.2±0.5)分、(22.8±2.2)分,多奈哌齐组分别为(65.2±5.9)分、(9.6±0.9)分、(19.4±2.4)分,联合组ADL、MMSE评分均明显高于多奈哌齐组(t=10.83、7.01,均P<0.001),BEHAVE-AD评分低于多奈哌齐组(t=-28.67,P<0.001)。治疗后,联合组血清Hcy、NSE、S100β水平分别为(17.8±3.6)μmol/L、(16.8±2.7)μg/L、(17.4±7.5)μg/L,均低于多奈哌齐组的(21.5±3.3)μmol/L、(20.4±3.7)μg/L、(23.5±5.1)μg/L(t=-5.08、-5.27、-4.51,均P<0.001)。联合组不良反应发生率为13.3%(6/45),高于多奈哌齐组的8.9%(4/45),但差异无统计学意义(χ^(2)=0.45,P=0.502)。结论盐酸多奈哌齐联合美金刚可有效改善AD患者的精神行为异常症状和认知功能,提高其日常生活能力,且并未增加不良反应,其临床应用价值较高。
Objective To analyze the effect of donepezil hydrochloride combined with memantine on cognitive function in patients with Alzheimer's disease(AD).Methods A randomized controlled trial was conducted among 90 patients with AD who were treated at the Zaozhuang Mental Health Center from January 2021 to March 2023.The patients were divided into a donepezil group and a combination group using a random number table grouping method,with 45 patients in each group.The donepezil hydrochloride group received only oral administration of donepezil hydrochloride tablets,while the combination group received oral administration of both donepezil hydrochloride tablets and memantine tablets.The two groups were continuously treated for 12 weeks.Before and after treatment,the Activities of Daily Living scale(ADL)score,the Behavioral Pathology in Alzheimer's Disease Rating Scale(BEHAVE-AD)score,the Mini-Mental State Scale(MMSE)score,and biochemical indicators(homocysteine,neuron-specific enolase,and S100β)were compared between the two groups.Adverse drug reactions were observed in each group.Results After treatment,the ADL,BEHAVE-AD,and MMSE scores in the combination group were(78.9±6.1)points,(5.2±0.5)points,and(22.8±2.2)points,respectively,and they were(65.2±5.9)points,(9.6±0.9)points,and(19.4±2.4)points,respectively,in the donepezil hydrochloride group.The ADL and MMSE scores in the combination group were significantly higher than those in the donepezil hydrochloride group(t=10.83,7.01,both P<0.001).The BEHAVE-AD score in the combination group was significantly lower than that in the donepezil hydrochloride group(t=-28.67,P<0.001).After treatment,serum levels of homocysteine,neuron-specific enolase,and S100βin the combination group were(17.8±3.6)μmol/L,(16.8±2.7)μg/L,and(17.4±7.5)μg/L,respectively,which were significantly lower than(21.5±3.3)μmol/L,(20.4±3.7)μg/L,and(23.5±5.1)μg/L in the donepezil hydrochloride group(t=-5.08,-5.27,-4.51,all P<0.001).The incidence of adverse drug reactions in the combination grou
作者
刘景妨
刘景艳
宋广文
Liu Jingfang;Liu Jingyan;Song Guangwen(Dementia Ward,Zaozhuang Mental Health Center,Zaozhuang 277000,Shandong Province,China;Department of Pharmacy,Zaozhuang Central Hospital,Shandong Healthcare Group,Zaozhuang 277000,Shandong Province,China)
出处
《中国基层医药》
CAS
2024年第1期29-33,共5页
Chinese Journal of Primary Medicine and Pharmacy
