美金刚对阿尔茨海默病伴精神障碍患者治疗的研究

摘要

Objective To examine the efficacy-namely, improved cognition and reduced psychiatric symptoms of memantine on Alzheimer's disease (AD) with psychiatric symptoms. Methods In this open-labeled study, subject enrollment took reference on the diagnostic criteria of "very probable AD" as established by National Institute of Neurology, Communicative Disorders and Stroke and the Alzheimer's disease and Related Disorders Association (NINCDS—ADRDA). Sixty consecutive patients with AD were randomly allocated to receive a 12-week memantine (memantine treatment group) and piracetam therapy (conventional treatment group), respectively. The efficacy was determined by mental state examination (MMSE), neuropsychiatric inventory (NPI) and torment scale of nurse (TSN). Results Of 58 patients completed the study, a 12-week memantine therapy led to improved cognition, increased MMSE scores and reduced NPI and TSN scores compared with conventional treatment group (all P<0.05). Conclusion Memantine may improve cognition and markedly ameliorate psychiatric symptoms in patients with moderate-to-severe AD, thus reducing the burden of nursing care.%目的 研究美金刚治疗阿尔茨海默病(AD)伴精神障碍患者的认知改善和精神症状减轻的疗效. 方法 采用开放性对照研究,诊断入组标准采用美国国立神经病、语言交流障碍和卒中研究所-老年性痴呆及相关疾病学会(NINCDS-ADRDA)制定的“很可能AD”诊断标准.共纳入60例AD患者,按就诊或住院顺序分为美金刚组及传统治疗组(服用吡拉西坦),连续服药12周.应用简易智力状态检查(MMSE)和神经精神症状问卷(NPI)和护理者苦恼分级评分评价疗效.结果 58例患者完成实验.美金刚组治疗后12周患者认知功能显著改善,MMSE评分显著增高,NPI评分显著降低,护理者苦恼分级评分显著降低.与传统治疗组比较,美金刚组MMSE评分变化、NPI评分变化以及护理者苦恼分级评分变化显著改善,差异均有统计学意义(P＜0.05).结论 盐酸美金刚可改善中、重度AD患者的认知功能,尤其明显改善患者精神症状,并减轻照料者负担.