發(fā)布時間：2018-08-29 07:35

【摘要】：目的探討多奈哌齊對阿爾茨海默病(AD)患者臨床療效。方法 AD患者按照簡易智能精神狀態(tài)量表(MMSE),分為輕度、中度和重度組各40例。所有患者治療前2 w停用其他治療藥物,前4 w給予多奈哌齊5 mg/d口服,4~8 w給予10 mg/d口服,療程24 w,同時選取36例健康老年體檢者進行對照。對各組患者的治療前后MMSE評分、血清同型半胱氨酸(HCY)、載脂蛋白E(ApoE)和C反應蛋白(CRP)進行測定。結果多奈哌齊治療后輕度、中度和重度AD患者MMSE評分與治療前相比有明顯的改善(P0.01,P0.01,P=0.012)。臨床療效比較發(fā)現(xiàn)三組患者治療結果有一定的差異(χ2=10.43,P=0.005),多奈哌齊對輕度和中度AD患者緩解程度明顯強于重度AD患者(χ2=9.038,P=0.003;χ2=4.267,P=0.039)。各組AD患者的CRP和HCY較健康對照組有顯著升高(P0.01,P0.01和P0.01),而且隨著疾病程度的加重,CRP與HCY水平也逐漸顯著提升(P0.05);而各組AD患者的ApoE較健康對照組有顯著下降(P0.01,P0.01和P0.01),而且隨著疾病程度的加重,ApoE水平也逐漸下降,但無顯著差異(P0.05)。輕度、中度和重度AD患者治療有效患者的CRP和HCY水平較無效患者顯著下降(P0.05),而ApoE水平則無明顯變化(P0.05)。結論多奈哌齊對不同程度AD患者,尤其是輕中度AD患者有顯著的臨床和血清學療效,且無明顯的副作用,安全性高。
[Abstract]:Objective to investigate the clinical effect of Donepezil on (AD) patients with Alzheimer's disease. Methods AD patients were divided into mild, moderate and severe groups according to simple Mental State scale (MMSE),). All the patients stopped taking other drugs 2 weeks before treatment, and 4 weeks after treatment, the patients were treated with Donepezil for 5 mg/d and 4 weeks for 10 mg/d. The course of treatment was 24 weeks. At the same time, 36 healthy elderly people were selected as control group. MMSE scores, serum homocysteine (HCY), apolipoprotein E (ApoE) and C-reactive protein (CRP) were measured before and after treatment. Results the MMSE scores of mild, moderate and severe AD patients were significantly improved after Donepezil treatment (P0.01, P0.01, P0.012). There were some differences in the treatment results among the three groups (蠂 ~ 2 / 10. 43 / P ~ (0.005). The remission degree of Donepezil in mild and moderate AD patients was significantly higher than that in severe AD patients (蠂 ~ (2) 9.038 / P ~ (0.003); 蠂 ~ (2) 4.267) P ~ (0.039). The levels of CRP and HCY in AD patients in each group were significantly higher than those in healthy control group (P0.01 and P0.01), and the levels of CRP and HCY increased gradually with the severity of disease (P0.05), while the ApoE levels in AD patients in each group were significantly lower than those in the healthy control group (P0.01 and P0.01), while those in AD patients in each group were significantly lower than those in the healthy control group (P0.01 and P0.01). The ApoE level decreased gradually with the severity of the disease. But there was no significant difference (P0.05). The levels of CRP and HCY in mild, moderate and severe AD patients were significantly lower than those in ineffective patients (P0.05), while ApoE levels did not change significantly (P0.05). Conclusion Donepezil has significant clinical and serological efficacy in patients with different levels of AD, especially in mild and moderate AD patients, with no obvious side effects and high safety.
【作者單位】： 遼寧省人民醫(yī)院神經內二科;
【分類號】：R749.16

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