阿尔茨海默病药物治疗的中英指南对比及解析

阿尔茨海默病（AD）的临床症状多样且以认知功能损害为主，给患者和家庭带来了巨大的精神压力和沉重的经济负担。目前尚无根治AD的药物，临床上常采用胆碱酯酶抑制剂和美金刚改善AD症状，但其疗效不一且安全性和成本效果性存在差异。为给患者选择安全、有效、经济的用药方案，中国和英国分别在2018年更新发表了AD药物治疗相关的指南。中国发布《2018中国痴呆与认知障碍诊治指南（二）：阿尔茨海默病诊治指南》在AD的诊断、药物治疗和临床疗效进行了阐述，英国国家卫生与临床优化研究所（NICE）发布的Donepezil，galantamine，rivastigmine and memantine for the treatment of Alzheimer's disease进行AD常用治疗药物的临床效果和药物经济学方面的分析。本文重点比较两个指南在药物方面的异同之处，旨在为临床医生和基层医生开具AD治疗药物时提供更多参考。

Comparison and Interpretation of Chinese and British Guidelines about Therapeutic Drugs for Alzheimer's DiseaseZHANG

The clinical symptoms of AD are various，mainly about cognitive function impairment，imposing huge mental and economic burdens on patients and their families.So far，there is no curative treatment for AD.It's widely admitted that acetylcholinesterase inhibitors and memantine could alleviate symptoms of AD，but the clinical efficacy，safety and cost-effectiveness of these drugs are different.To provide safe，effective and inexpensive pharmaceutical treatments for AD，in 2018，China issued the updated Chinese Guidelines for Diagnosis and Management of Cognitive Impairment and Dementia （Ⅱ）：Diagnosis and Treatment of Alzheimer's Disease，with explanation and elaboration of the diagnosis，drug therapies and their clinical efficacies for AD，and the U.K.'s NICE issued Evidence-based Recommendations on donepezil，galantamine，rivastigmine and memantine for the treatment of Alzheimer's disease，with comparative analysis of these common therapeutic drugs for AD in terms of clinical efficacy and pharmacoeconomics.We compared the similarities and differences of drug therapies for AD between these two guidelines，aiming to offer a reference for clinicians or primary care physicians prescribing drugs for AD.