孟旭 张鹏
[摘要] 目的 探讨多奈哌齐联合美金刚对老年痴呆精神行为障碍的疗效及认知功能动态影响。 方法 选取2015年6月～2016年6月我院收治的老年痴呆精神行为障碍患者70例作为研究对象，按照治疗方法不同将其分成观察组和对照组，每组各35例，对照组采用吡拉西坦治疗，观察组采用多奈哌齐联合美金刚治疗，随访2年，对两组疗效和治疗前后患者认知功能评分（MMSE）和日常生活能力评分（ADL）以及安全性进行比较。 结果 观察组治疗总有效率为88.57%，对照组为62.86%，观察组明显高于对照组（χ2=6.293，P<0.05）;在MMSE和ADL评分上，两组治疗后6个月、2年均有明显提高（P<0.05），且观察组与对照组比较提高水平更明显（P<0.05）;观察组不良反应发生率为14.29%，对照组为17.14%，两组比较无明显差异（χ2=0.108，P>0.05）。 结论 老年痴呆精神行为障碍患者采用多奈哌齐联合美金刚治疗，能够改善患者的认知功能和日常生活能力。
[关键词] 多奈哌齐;美金刚;老年痴呆精神行为障碍;认知功能
[中图分类号] R749.16 [文献标识码] B [文章编号] 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
老年癡呆是一种起病隐匿进行性发展的神经系统退行性疾病，临床上以记忆障碍、失语、失认、失用、行为障碍等表现为特征，给患者的行为生活功能造成严重影响，而且治疗耗时长、进展缓慢，给家庭和社会造成了沉重负担[1]。临床上老年痴呆精神行为障碍多采用吡拉西坦治疗，但是半衰期较长、疗效缓慢，而多奈哌齐和美金刚是治疗老年痴呆的对症治疗药物，对患者的认知功能能够起到明显的改善作用[2]。本文选取我院在2015年6月～2016年6月收治的老年痴呆精神行为障碍患者，予以多奈哌齐联合美金刚的治疗效果满意，现报道如下。
