奎硫平与奥氮平治疗血管性痴呆精神行为症状的对照研究

目的：探讨奎硫平与奥氮平对血管性痴呆（VD）精神行为症状的疗效及不良反应。方法：将88例VD患者分为奎硫平组与奥氮平组,治疗8周。治疗前、治疗2、4和8周以简易智力状况检查表（MMSE）和日常生活能力量表（ADL）评定患者痴呆状况;以痴呆病理行为评定量表（BEHAVE-AD）评定疗效,治疗中出现的症状量表（TESS）评定不良反应。结果：两组治疗后BEHAVE-AD评分显著减少（P〈0.01）,MMSE评分与治疗前比较差异无显著性（P〉0.05）、ADL有明显改善（P〈0.05）,两组间比较差异无显著性（P〉0.05）;奥氮平组的锥体外系反应、口干、头昏、嗜睡、体质量增加、便秘较奎硫平组显著（P〈0.01）。结论：奎硫平与奥氮平对VD患者的精神行为症状均有较好的疗效,奎硫平安全性更高。

Comparative study of quetiapine and olanzapine on behavioral and psychological symptoms of vascular dementia

Objective： To explore the efficacy and side effects of quetiapine and olanzapine on behavioral and psychological symptoms of vascular dementia （VD） . Method： 88 VD patients were divided into quetiapine group and olanzapine group for 8 week treatments. Activities of daily living scale （ADL） as well as minimental state examination （MMSE） were used to assess dementia status,behavioral pathology in Alzheimer＇s disease rating scale （BEHAVE-AD） to assess efficacy,and treatment emergent symptom scale （TESS） to assess side effects at baseline,week 2,4 and 8. Results： The two groups did not show significant decreases on MMSE （P 0. 05） but on BEHAVE-AD and ADL （P 0. 05） after treatment. There were no significant differences found in two groups. Side effects such as extrapyramidal reactions,thirst,dizziness,drowsiness,weight gain and constipation were worse in olanzapine group than in quetiapine group（P 0. 01） . Conclusion： Quetiapine and olanzapine are effective for improving behavioral and psychological symptoms of VD,and quetiapine has better safety than olanzapine.