探讨兴奋性氨基酸受体拮抗剂治疗中度阿尔茨海默病的临床疗效
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摘要
目的分析采用兴奋性氨基酸受体拮抗剂替换多奈哌齐治疗对中度阿尔茨海默病患者的临床疗效和安全性。方法选择我院于2016年10月—2018年10月收治的中度阿尔茨海默病患者80例作为研究对象。按照治疗手段的不同,将其分为对照组(40例,采用多奈哌齐治疗)和观察组(40例,采用兴奋性氨基酸受体拮抗剂治疗)。结果观察组患者好转率为85.0%,高于对照组好转率的72.5%,同时观察组患者的MMSE评分为(19.56±1.51)分,高于对照组MMSE评分的(17.25±3.42)分;观察组患者的ADL评分为(82.12±15.42)分,高于对照组ADL评分的(62.36±24.12)分,差异均有统计学意义(P<0.05)。但两组并发症发生率比较,差异无统计学意义(P> 0.05)。结论在对中度阿尔茨海默病患者实施临床治疗时,将兴奋性氨基酸受体拮抗剂替换多奈哌齐治疗,可显著提升治疗效果,同时治疗安全性较好,有较高临床使用价值。
Objective To analyze the clinical efficacy and safety of the replacement of donepezil with excitatory amino acid receptor antagonist in the treatment of moderate Alzheimer's disease. Methods 80 patients with moderate Alzheimer's disease admitted to our hospital from October2016 to October 2018 were selected as the subjects of study. According to the different treatment methods, they were divided into control group(40 cases treated with donepezil) and observation group(40 cases treated with excitatory amino acid receptor antagonist). Results The improvement rate of the observation group was 85.0%, which was higher than 72.5% of the control group. At the same time, the MMSE score of the observation group was(19.56±1.51) points, which was higher than that of the control group(17.25±3.42) points. The ADL score of the observation group was(82.12±15.42)points, which was higher than that of the control group(62.36±24.12) points.The difference was statistically significant(P < 0.05). However, there was no significant difference in the incidence of complications between the two groups(P > 0.05). Conclusion In the clinical treatment of moderate Alzheimer's disease, the replacement of donepezil with excitatory amino acid receptor antagonist can significantly improve the therapeutic effect, while the treatment is safe and has high clinical value.
Objective To analyze the clinical efficacy and safety of the replacement of donepezil with excitatory amino acid receptor antagonist in the treatment of moderate Alzheimer's disease. Methods 80 patients with moderate Alzheimer's disease admitted to our hospital from October2016 to October 2018 were selected as the subjects of study. According to the different treatment methods, they were divided into control group(40 cases treated with donepezil) and observation group(40 cases treated with excitatory amino acid receptor antagonist). Results The improvement rate of the observation group was 85.0%, which was higher than 72.5% of the control group. At the same time, the MMSE score of the observation group was(19.56±1.51) points, which was higher than that of the control group(17.25±3.42) points. The ADL score of the observation group was(82.12±15.42)points, which was higher than that of the control group(62.36±24.12) points.The difference was statistically significant(P < 0.05). However, there was no significant difference in the incidence of complications between the two groups(P > 0.05). Conclusion In the clinical treatment of moderate Alzheimer's disease, the replacement of donepezil with excitatory amino acid receptor antagonist can significantly improve the therapeutic effect, while the treatment is safe and has high clinical value.
引文
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[7]李胜利,李银银.丁苯酞联合美金刚治疗阿尔茨海默病的疗效及对患者认知功能的影响[J].现代诊断与治疗,2018,29(08):1254-1256.
[8]Knapp M,King D,Romeo R,et al.Cost-effectiveness of donepezil and memantine in moderate to severe Alzheimer's disease(the DOMINO-AD trial)[J].International Journal of Geriatric Psychiatry,2017,32(12):1205-1216.
[9]孙丽莹.盐酸美金刚与卡巴拉汀联合治疗对比卡巴拉汀单药对阿尔茨海默病患者日常生活能力的影响[J].临床医药文献电子杂志,2018,5(31):71.
[10]Chen R,Chan PT,Chu H,et al.Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease:A meta-analysis[J].Plos One,2017,12(8):e0183586.
[11]刘瑞,高见,朱江,等.盐酸美金刚联合盐酸多奈哌齐治疗阿尔茨海默病患者精神行为症状临床研究[J].临床军医杂志,2017,45(12):1272-1274.
[12]宋杨,孙雅萍.多奈哌齐联合美金刚对阿尔茨海默病患者认知功能与行为能力的作用及安全性[J].中国老年学杂志,2017,37(21):5412-5414.
[2]邓育,娄元菊,钟明洁,等.美金刚联合抗抑郁药物治疗阿尔茨海默病伴焦虑抑郁激越症状的临床疗效[J].中国药物经济学,2018,13(8):48-51.
[3]中国痴呆与认知障碍写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会.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[J].中华医学杂志,2018,98(13):971-977.
[4]章瑜,谢健.美金刚对阿尔茨海默病患者精神行为症状和睡眠结构的影响[J].浙江医学,2018,40(11):1175-1178.
[5]Ishikawa I,Shinno H,Ando N,et al.The effect of memantine on sleep architecture and psychiatric symptoms in patients with Alzheimer's disease[J].Acta Neuropsychiatrica,2016,28(3):157-164.
[6]万素馨,向毅,罗亚玲.多奈哌齐联合美金刚治疗阿尔茨海默病的有效性及安全性系统评价[J].药学实践杂志,2018,36(3):260-264,281.
[7]李胜利,李银银.丁苯酞联合美金刚治疗阿尔茨海默病的疗效及对患者认知功能的影响[J].现代诊断与治疗,2018,29(08):1254-1256.
[8]Knapp M,King D,Romeo R,et al.Cost-effectiveness of donepezil and memantine in moderate to severe Alzheimer's disease(the DOMINO-AD trial)[J].International Journal of Geriatric Psychiatry,2017,32(12):1205-1216.
[9]孙丽莹.盐酸美金刚与卡巴拉汀联合治疗对比卡巴拉汀单药对阿尔茨海默病患者日常生活能力的影响[J].临床医药文献电子杂志,2018,5(31):71.
[10]Chen R,Chan PT,Chu H,et al.Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease:A meta-analysis[J].Plos One,2017,12(8):e0183586.
[11]刘瑞,高见,朱江,等.盐酸美金刚联合盐酸多奈哌齐治疗阿尔茨海默病患者精神行为症状临床研究[J].临床军医杂志,2017,45(12):1272-1274.
[12]宋杨,孙雅萍.多奈哌齐联合美金刚对阿尔茨海默病患者认知功能与行为能力的作用及安全性[J].中国老年学杂志,2017,37(21):5412-5414.