卡巴拉汀治疗阿尔茨海默病的远期疗效观察

目的观察卡巴拉汀治疗阿尔茨海默病(AD)的远期疗效和安全性。方法选择阿尔茨海默病患者56例,随机分为治疗组28例和对照组28例。对照组服用脑复康、银杏叶片进行常规治疗,治疗组在常规治疗的基础上每日加服卡巴拉汀3～9mg。以简易智能状态检查量表(mini mental state examination,MMSE)、AD评估量表认知分量表(ADAS-cog)、日常生活活动能力量表(ADL)、总体衰退量表(GDS)等评分作为主要评价指标,比较2组患者在治疗前与治疗3、6、12、18、24、30和36个月后的认知能力、精神状况、日常生活能力的改善情况。结果治疗组患者MMSE、ADAS-cog、GDS评分6个月以后明显优于对照组,ADL评分12个月以后明显优于对照组,差异有统计学意义(P<0.05)。卡巴拉汀在连续用药12个月内疗效递增,12个月时疗效最佳,之后开始下降,36个月时仍明显优于基线水平。MMSE、ADAS-cog、GDS评分改善程度优于ADL。结论卡巴拉汀治疗AD远期疗效满意,安全可靠。

Clinical observation of the long-term efficacy of rivastigmine in the treatment of Alzheimer's disease

Objective To evaluate the long-term efficacy and safety of rivastigmine in treating patients with Alzheimer's disease(AD).Methods A total of 56 cases of AD were randomly divided into a control group and a treatment group of 28 patients each.The control group received conventional therapy with piracetam and Yinxingyepian,while the treatment group,on the basis of conventional therapy,were administrated with 3-9 mg of rivastigmine everyday.The improvement of recognition ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),AD assessment scale-cognitive subscale(ADAS-cog),ADL and GDS.The scores are compared between the 2 groups before the treatment and after 3,6,12,18,24,30 and 36 months of the treatment respectively.Results The scores of MMSE,ADAS-cog,ADL and GDS in the treatment group presented more satisfactory figures compared with those of the control group and showed statistically significant difference after 6 months(P<0.05).Rivastigmine showed steadily increasing curative effects in the first consecutive 12 months,with the best effects being in the twelfth month followed by a gradual decline in the effects in the following months,but the effects in the 36th month was still superior to the baseline.The levels of improvement in the MMSE, ADAS-cog and GDS were superior to that in the ADL.Conclusion Rivastigmine is a long-term effective and safe treatment of Alzheimer's disease.