喹硫平治疗阿尔茨海默病精神行为症状的对照研究

目的 探讨喹硫平治疗阿尔茨海默病精神行为症状的疗效和安全性。方法 选择2015年1月至2017年1月上海市长宁区精神卫生中心收治的伴有精神行为症状的阿尔茨海默病患者63例，将入组患者采用分层区组方法随机分为喹硫平组和美金刚组。喹硫平组32例，给予喹硫平片治疗。美金刚组31例，给予美金刚片治疗。治疗后第1、2、4、8、12、16、20、24周末观察精神行为症状和认知功能的疗效及头晕、困倦等副反应。结果 治疗第24周末，喹硫平组与美金刚组神经精神科问卷总分均下降，不同时间点之间差异有统计学意义（F=194.29，P=0.00）。治疗24周后，两组患者妄想、幻觉、激越、焦虑等因子较基线均有显著下降，差异有统计学意义（P<0.05）。第1周末、第2周末喹硫平组患者精神行为症状的有效率高于美金刚组，差异有统计学意义（P<0.05）。喹硫平组有3例患者发生头晕，困倦2例，乏力1例，血压降低2例。美金刚组有1例患者发生头晕，困倦3例，乏力2例，血压降低1例。两组患者不良反应发生率的差异无统计学意义（P>0.05）。结论 喹硫平与美金刚均能有效缓解阿尔茨海默病患者的精神行为症状，喹硫平比美金刚起效更快。

A controlled study of quetiapine onbehavioral and psychological symptoms of dementia

Objective To investigate the efficacy and safety of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia. Methods The subjects were patients with Alzheimer''s disease with mental behavior symptoms admitted to the Changning District Mental Health Center from Jan 2015 to Jan 2017. A total of 63 patients were enrolled in the study, who were randomly divided into quetiapine or memantine group. Thirty-two patients in quetiapine group were treated with quetiapine, while thirty-one patients in memantine group were treated with memantine. The effects of mental behavioral symptoms and cognitive function and side effects such as dizziness and drowsiness were observed at the 1st, 2nd, 4th, 8th, 12th, 16th, 20th, and 24th weekend after treatment. Results At the 24th weekend of treatment, the total scores of the neuropsychiatric inventory in both quetiapine group and memantine group decreased, and the difference among the different time points was statistically significant (F=194.29, P=0.00). After 24 weeks of treatment, the factor scores such as delusion, hallucination, agitation, and anxiety decreased significantly from baseline in two groups, and the difference was statistically significant (P<0.05). At the 1st and 2nd weekend, the effective rate of behavioral and psychological symptoms of dementia in quetiapine group was higher than that in memantine group, and the difference was statistically significant (P<0.05). In quetiapine group, dizziness occurred in three cases, drowsiness in two cases, fatigue in one case, and decrease of blood pressure in two cases. In memantine group, dizziness occurred in one case, drowsiness in three cases, fatigue in two cases, and decrease of blood pressure in one case. The difference in the incidence of side effects between two groups was not statistically significant (P>0.05). Conclusion Both quetiapine and memantine can effectively relieve the behavioral and psychological symptoms of dementia. Quetiapine takes effect faster than memantine does.