西酞普兰治疗阿尔茨海默病患者精神行为症状与认知障碍的对照研究被引量：18

Comparative study of citalopram in treatment of behavioral and psychological symptoms of dementia and cognitive function in Alzheimer＇s disease patients

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摘要目的观察西酞普兰治疗阿尔茨海默病（Alzheimer＇s disease，AD）患者的精神行为症状、认知障碍的疗效和安全性。方法从2015年4月至2016年2月在青岛市精神卫生中心收集80例中度AD（根据临床痴呆评定量表，CDR）并伴有精神行为症状的患者，将其随机分为治疗组和对照组，每组各40例。治疗组给予西酞普兰10～30 mg/d治疗，对照组给予同剂量的安慰剂，两组均口服美金刚10 mg bid，疗程12周。用简易精神状态检查（MMSE）测量认知功能，神经精神科问卷（NPI）测量BPSD，以及副反应量表（TESS）评定有无不良反应，比较两组患者的疗效和安全。结果治疗组和对照组经12周治疗后，两组减分值分别（0.67±0.77）分和（0.26±0.68）分，两组减分值相比较，差异有统计学意义（t＝2.49，P＝0.02）；治疗组和对照组经过12周治疗后在NPI量表中激越/攻击（t＝2.986，P＝0.04）、情感淡漠/漠不关心（t＝3.144，P＝0.002）、抑郁/心境恶劣（t＝6.094，P＝0.000）和焦虑（t＝6.496，P＝0.000）四个方面差异有统计学意义，最常见的不良反应为头晕、头痛、疲乏、恶心，治疗组在西酞普兰剂量为30 mg/d时出现QTc间期延长，TESS量表未见明显差异。结论西酞普兰联合美金刚治疗中度AD，可以改善精神行为症状，尤其是激越/攻击、情感淡漠/漠不关心、抑郁/心境恶劣和焦虑方面，认知功能也可改善，安全性高，不良反应小。 ObjectiveTo observe the efficacy and safety of citalopram in the treatment of behavioural and psychological symptoms of dementia （BPSD）and cognitive function of Alzheimer＇s disease（AD） patients.MethodsFrom April 2015 to February 2016, 80 cases of moderate Alzheimer＇s disease （according to the clinical dementia rating scale, CDR） with symptoms of BPSD in Qingdao Mental Health Center were collected and randomly divided into treatment group and control group.Treatment group was given citalopram （10 to 30 mg/d ）, the control group was given the same dose of placebo, and the patients in both group were given memantine （10 mg/bid） for 12 weeks.Simple mental state examination （MMSE） was used to measure cognitive function.Neural psychiatric questionnaire （NPI） measurement was used to evaluate BPSD and the TESS was used to assess adverse effects.ResultsDecreased scores of MMSE between the treatment group and the control group were respectively （0.67±0.77） and （0.26±0.68） after 12 weeks of treatment.There was significant difference in decreased scores of MMSE between the two groups （t=2.49, P=0.02） .The scores of NPI in agitation/attack（t=2.986, P=0.04）, apathy（t=3.144, P=0.002）, indifference/dysthymia （t=6.094, P=0.000）and anxiety（t=6.496, P=0.000） showed statistically significant differences between the two groups.There were no significant difference in TESS scores（P〉0.05）. The most frequently adverse events in the study included dizziness, headache, fatigue and nausea.QTc interval prolongation were found in participants treated with 30 mg citalopram per day in the study group.ConclusionCitalopram is an effective and safe drug in the treatment of BPSD and cognitive function associated with moderate AD.

作者刘磊孔伶俐王春霞刘春文

机构地区青岛市精神卫生中心老年科青岛大学医学部生理病理学系

出处《中华行为医学与脑科学杂志》 CAS CSCD 北大核心 2018年第1期52-55,共4页 Chinese Journal of Behavioral Medicine and Brain Science

基金青岛市卫生局医药科研计划项目（2014-WJZD147）

关键词西酞普兰阿尔茨海默病精神行为症状认知功能 Citalopram Alzheimer＇s disease Behavioral and psychological symptoms of dementia Cognitive function

分类号 R749.16 [医药卫生—神经病学与精神病学]

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