孟旭 張鵬

[摘要] 目的 探討多奈哌齊聯(lián)合美金剛對(duì)老年癡呆精神行為障礙的療效及認(rèn)知功能動(dòng)態(tài)影響。 方法 選取2015年6月～2016年6月我院收治的老年癡呆精神行為障礙患者70例作為研究對(duì)象，按照治療方法不同將其分成觀察組和對(duì)照組，每組各35例，對(duì)照組采用吡拉西坦治療，觀察組采用多奈哌齊聯(lián)合美金剛治療，隨訪2年，對(duì)兩組療效和治療前后患者認(rèn)知功能評(píng)分（MMSE）和日常生活能力評(píng)分（ADL）以及安全性進(jìn)行比較。 結(jié)果 觀察組治療總有效率為88.57%，對(duì)照組為62.86%，觀察組明顯高于對(duì)照組（χ2=6.293，P<0.05）;在MMSE和ADL評(píng)分上，兩組治療后6個(gè)月、2年均有明顯提高（P<0.05），且觀察組與對(duì)照組比較提高水平更明顯（P<0.05）;觀察組不良反應(yīng)發(fā)生率為14.29%，對(duì)照組為17.14%，兩組比較無(wú)明顯差異（χ2=0.108，P>0.05）。 結(jié)論 老年癡呆精神行為障礙患者采用多奈哌齊聯(lián)合美金剛治療，能夠改善患者的認(rèn)知功能和日常生活能力。

[關(guān)鍵詞] 多奈哌齊;美金剛;老年癡呆精神行為障礙;認(rèn)知功能

[中圖分類(lèi)號(hào)] R749.16? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2019）04-0081-04

[Abstract] Objective To investigate the dynamic effect of donepezil combined with memantine on the efficacy and cognitive function of senile dementia complicated with mental behavior disorder. Methods 70 patients with senile dementia complicated with mental behavior disorders who were admitted to our hospital from June 2015 to June 2016 were selected as study subjects. According to the different treatment methods， they were divided into observation group and control group， with 35 cases in each group. The control group was given piracetam. The observation group was given donepezil combined with memantine. After 2 years of follow-up visit， the efficacy， cognitive function score （MMSE） and daily living ability score（ADL） and safety before and after treatment were compared in both groups. Results The total effective rate in the observation group was 88.57%， and that in the control group was 62.86%. The observation group was significantly higher than the control group（χ2=6.293， P<0.05）; in the MMSE and ADL scores， the two groups were significantly improved 6 months and 2 years after treatment（P<0.05）， and the improvement level in the observation group was more significant than that in the control group （P<0.05）; the incidence rate of adverse reactions in the observation group was 14.29%， and that in the control group was 17.14%. There was no significant difference between the two groups（χ2=0.108， P>0.05）. Conclusion Donepezil combined with memantine for the patients with senile dementia complicated with mental behavior disorder can improve their cognitive function and daily living ability.

[Key words] Donepezil; Memantine; Senile dementia complicated with mental behavior disorder; Cognitive function

老年癡呆是一種起病隱匿進(jìn)行性發(fā)展的神經(jīng)系統(tǒng)退行性疾病，臨床上以記憶障礙、失語(yǔ)、失認(rèn)、失用、行為障礙等表現(xiàn)為特征，給患者的行為生活功能造成嚴(yán)重影響，而且治療耗時(shí)長(zhǎng)、進(jìn)展緩慢，給家庭和社會(huì)造成了沉重負(fù)擔(dān)[1]。臨床上老年癡呆精神行為障礙多采用吡拉西坦治療，但是半衰期較長(zhǎng)、療效緩慢，而多奈哌齊和美金剛是治療老年癡呆的對(duì)癥治療藥物，對(duì)患者的認(rèn)知功能能夠起到明顯的改善作用[2]。本文選取我院在2015年6月～2016年6月收治的老年癡呆精神行為障礙患者，予以多奈哌齊聯(lián)合美金剛的治療效果滿意，現(xiàn)報(bào)道如下。