摘要
目的对照分析奥氮平、奎硫平对阿尔茨海默病（AD）患者吞咽功能的影响。方法伴精神行为症状的AD患者采用随机数字表法分组，分别接受奥氮平（奥氮平组，n=42）、奎硫平（奎硫平组，n=38）治疗，疗程6周；以洼田饮水试验联合血氧饱和度（SaO2）监测法评估患者治疗前、治疗后的吞咽功能。结果（1）2组治疗后洼田饮水试验评分均高于治疗前，差异有统计学意义（分别t=2．682、2．040，均P〈0．05）；奥氮平组饮水试验时SaO2的下降值高于治疗前，差异有统计学意义（t=4．313，P〈0．01），奎硫平组治疗前后的差异无统计学意义（P〉0．05）；奥氮平组治疗后饮水试验时SaO2的下降值高于奎硫平组，差异有统计学意义（t=2．155，P〈0．05）。（2）29％（23／80）的AD患者在治疗前即有吞咽障碍；奥氮平组治疗后新出现的吞咽障碍患者比例高于奎硫平组，差异有统计学意义（分别为9／31、2／26，x2=4．135，P〈0．05）。（3）2组简易精神状态检查（MMSE）评分治疗前后的差异均无统计学意义（均P〉0．05），AD病理行为量表（BE．HAVE-AD）评分降低，均差异有统计学意义（分别t=3．019、2．867，均P〈0．01）；治疗后2组间MMSE、BE—HAVE-AD评分的差异无统计学意义（P〉0．05）。结论奥氮平、奎硫平对AD患者吞咽功能均有不良影响，前者更显著。
Objective To evaluate the harmful effects of olanzapine and quetiapine therapeusis on swallo- wing ability in patients with Alzheimer＇disease （AD）. Methods AD inpatients with behavioral and psychological symptoms were randomly divided into two groups, treated with olanzapine （ n= 42 ） or quetiapine （ n=38 ） for 6 weeks. The patients were assessed with Kubota＇s water swallowing test and arterial oxygen saturation（ SaO2 ） monitoring pre and pro treatment. Results After treatment, a signifieant higher score of water swallowing test （ t = 2.682,2.040;both P〈0.05）in either of two groups, and a significant raised degrade of SaO2 only in olanzapine group（ t=4.313, P〈0.01 ）but not in quetiapine group （P〉0.05）were observed. There was a significant higher degrade of SaO2 in olanzapine group than that in quetiapine group （ t=2.155, P〈0.05）at 6 weekend of the study. Be- fore pharmacon, about 29% （23/80）AD subjects were diagnosed as dysphagia. After pharmacon, more emerging dysphagia patients were surveyed in olanzapine group compared with that in quetiapine group（ 9/31 vs 2/26,X2= 4.135, P〈0.05） . No significant change （both P〉0.05 ） in scores of mini-mental state examination（MMSE） and a significant reduced score （ t=3.019,2.867 ;both P〈0.01 ） of behavioral pathology in Alzheimer^disease rating scale （BEHAVE-AD） were found in both two groups at the end of study . There was no difference among the two groups with regard to score of MMSE or BEHAVE-AD after treatment （ both P〉0.05 ）. Conclusion Either olanzapine or quetiapine therapeutics might do some harmful effects on swallowing function in patients with AD, especially the former.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2015年第1期46-49,共4页
Chinese Journal of Behavioral Medicine and Brain Science
关键词
阿尔茨海默病
吞咽功能
奥氮平
奎硫平
Alzheimer＇disease
Swallowing ability
Olanzapine
Quetiapine
