喹硫平与利培酮治疗痴呆患者行为与精神障碍的临床对照分析Clinical comparative analysis of quetiapine and risperidone in the treatment of behavior and mental disorders in patients with dementia
李万里;于荣焕;张高才;
摘要(Abstract):
目的对照分析利培酮与喹硫平治疗痴呆患者行为与精神障碍的临床效果。方法回顾性选取2017-01―2020-01开封市中心医院痴呆伴行为与精神障碍患者100例,依据治疗方法分为喹硫平组(n=50)和利培酮组(n=50)2组,统计分析2组BEHAVE-AD评分、MMSE评分、临床疗效及不良反应发生情况。结果喹硫平组治疗后较治疗前的BEHAVE-AD评分、MMSE评分降低幅度均显著高于利培酮组(P<0.05)。喹硫平组总有效率为96.0%(48/50),利培酮组为94.0%(47/50),2组比较无显著性差异(P>0.05)。喹硫平组不良反应发生率4.0%(2/50),利培酮组为22.0%(11/50),喹硫平组显著低于利培酮组(P<0.05)。结论喹硫平治疗痴呆患者行为与精神障碍的临床效果优于利培酮。
关键词(KeyWords): 痴呆;利培酮;喹硫平;行为与精神障碍;BEHAVE-AD评分;MMSE评分
基金项目(Foundation): 开封市科技攻关项目(编号:130320)
作者(Authors): 李万里;于荣焕;张高才;
参考文献(References):
- [1] 陈晨,张基伟,吴天文,等.安理申联合奥拉西坦治疗血管性痴呆临床观察[J].中国实用神经疾病杂志,2019,22(13):1442-1447.DOI:10.12083/SYSJ.2019.13.205.
- [2] 王凡,王向阳,刘丽,等.丁苯酞对血管性痴呆的疗效Meta分析[J].中国实用神经疾病杂志,2019,22(10):1059-1063.DOI:10.12083/SYSJ.2019.10.139.
- [3] GEOFFREY M R,MICHAEL B F,CARY S K,et al.Innovations and changes in the ICD-11 classification of mental,behavioural and neurodevelopmental disorders[J].World Psychiatry,2019,18(1):3-19.DOI:10.1002/14651858.CD003154.pub6.
- [4] ISHIKAWA H,KAWAKAMI N,KESSLER R C,et al.Lifetime and 12-month prevalence,severity and unmet need for treatment of common mental disorders in Japan:results from the final dataset of World Mental Health Japan Survey[J].Epidemiol Psychiatr Sci,2016,25(3):217-229.DOI:10.1177/0269216318809571.
- [5] SAVVA M G,ZACCAI J,MATTHEWS F E,et al.Prevalence,correlates and course of behavioural and psychological symptoms of dementia in the population[J].Br J Psychiatry,2009,194(3):212-219.DOI:10.1192/bjp.bp.108.049619.
- [6] PETROVIC M,HURT C,COLLINS D,et al.Clustering of behavioural and psychological symptoms in dementia (BPSD):a European Alzheimer's disease consortium (EADC) study[J].Acta Clin Belg,2007,62(6):426-432.DOI:10.1179/acb.2007.062.
- [7] WANG J Y,HSIEH M H,LIN P C,et al.Parallel contagion phenomenon of concordant mental disorders among married couples:a nationwide cohort study[J].J Epidemiol Community Health,2017,71(7):640-647.DOI:10.1186/s12877-015-0008-1.
- [8] THOMAS D,WU K,KATH?FER S,et al.The antipsychotic drug chlorpromazine inhibits HERG potassium channels[J].Br J Pharmacol.2003,139(3):567-574.DOI:10.1038/sj.bjp.0705283.
- [9] LE S Y,CHOISY,YOUM J B,et al.Block of HERG human K(+) channel and IKr of guinea pig cardiomyocytes by chlorpromazine[J].J CardiovascPharmacol,2004,43(5):706-714.DOI:10.1097/00005344-200405000-00014.
- [10] BAUKE K,WILLEKE M,INDIRA T,et al.The MATCH cohort study in the Netherlands:rationale,objectives,methods and baseline characteristics of patients with (long-term) common mental disorders[J].Int J Methods Psychiatr Res,2017,26(1):1512.DOI:10.1016/j.jalz.2017.04.005.
- [11] MARTIN O,LAUREN Y,PHUONG L,et al.The impact of individual Cognitive Stimulation Therapy (iCST) on cognition,quality of life,caregiver health,and family relationships in dementia:A randomised controlled trial[J].PLoS Med,2017,14(3):1002269.DOI:10.1186/s13195-016-0188-8.
- [12] BARNES T R,BANERJEE S,COLLINS N,et al.Antipsychotics in dementia:prevalence and quality of antipsychotic drug prescribingin UK mental health services[J].Br J Psychiatry,2012,201(3):221-226.DOI:10.1192/bjp.bp.111.107631.
- [13] GARERI P,DE FAZIO P,MANFREDI V G,et al.Use and safety of antipsychotics in behavioral disorders in elderly people with dementia[J].Clin Psychopharmacol,2014,34(1):109-123.DOI:10.1097/JCP.0b013e3182 a6096e.
- [14] S.EVANSL,GAXIOLASA,AL-HAMZAWIA,et al.Socio-economic variations in the mental healthtreat-ment gap for people with anxiety,mood,andsubstance use disorders:Resultsfromthe WHO World Mental Health (WMH)Surveys[J].Psychol Med,2018,48(9):1560-1571.DOI:10.1186/s12955-014-0164-6.
- [15] PRICE D L,BONHAUS D W,MCFARLAND K.Pimavanserin,a 5-HT2A receptor inverse agonist,reverses psychosis-like behaviors in a rodent model of Alzheimer's disease[J]Behav Pharmacol,2012,23(4):426-433.DOI:10.1097/FBP.0b013e3283566082.
- [16] JASONRR,RANDY W,GREG F,et al.Acute Risk of Suicide and Suicide Attempts Associated With Recent Diagnosis of Mental Disorders:APopulation-Based,Propensity Score-Matched Analysis[J].Can J Psychiatry,2014,59(10):531-538.DOI:10.1007/s11673-019-09945-x.
- [17] DI FIORINO M,MONTAGNANI G,TRESPI G,et al.Extendedrelease quetiapine fumarate(quetiapine XR)versus risperidone in the treatment of depressive symptoms in patients with schizoaffective disorder or schizophrenia:a randomized,open-label,parallel-group,flexible-dose study[J].Int Clin Psychopharmacol,2014,29(3):166-176.DOI:10.1097/YIC.0000000000 000017.
- [18] PASTERNAK B,SVANSTR?M H,RANTHE M F,et al.Atypical antipsychotics olanzapine,quetiapine,and risperidone and risk of acute major cardiovascular events in young and middle-agedadults:a nationwide register-based cohort study in Denmark[J].CNS Drugs,2014,28(10):963-973.DOI:10.1007/s40263-014-0176-0.
- [19] PARK H Y,PARK J W,SONGH J,et al.The Association between Polypharmacy and Dementia:A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea[J].PLoS One,2017,12(1):169463.DOI:10.1186/s12888-017-1366-3.
- [20] RITA G,OWENA R,CELIA K R,et al.Investigating the genetic architecture of dementia with Lewy bodies:a two-stage genome-wide association study[J].Lancet Neurol,2018,17(1):64-74.DOI:10.1016/j.jamda.2018.07.005.
- [21] SILVA M A D,LEMOGNE C,MELCHIOR M,et al.Excess non-psychiatric hospitalizations among Employees with mental disorders:a10-year prospective study of the GAZEL cohort[J].Acta Psychiatr Scand,2015,131(4):307-317.DOI:10.1080/15622975.2017.1375556.
- [22] TRACY W,DANIEL P,LISA M,et al.Delirium and Mental Health History as Predictors of Aggression in Individuals with Dementia in Inpatient Settings[J].Aging Ment Health,2018,22(1):121-128.DOI:10.1136/bmjopen-2017-021125.
- [23] EMILYY Y C,HOLLYC Y L,SUZANNEH W S,et al.Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City:A Time-Series Study of Hong Kong Special Administrative Region[J].Int J Environ Res Public Health,2018,15(4):754.DOI:10.1186/s12877-016-0342-y.
- [24] DIMITY P,KAREN M,NIGELS,et al.Effectiveness of a peer-mediated educational intervention in improving general practitioner diagnostic assessment and management of dementia:a cluster randomized controlledtrial[J].BMJ Open,2018,8(8):21125.DOI:10.1186/s12889-018-6129-7.
- [25] WANG M,PENG H,PENG Z,et al.Efficacy and safety of ginkgo preparation in patients with vascular dementia:A protocol for systematic review and meta-analysis[J].Medicine (Baltimore),2020,99(37):e22209.DOI:10.1097/MD.0000000000022209.
- [26] BALL E L,OWEN-BOOTH B,GRAY A,et al.Aromatherapy for dementia[J].Cochrane Database Syst Rev,2020,8(8):CD003150.DOI:10.1002/14651858.CD003150.pub3.
- [27] MCCOLLUM L,KARLAWISH J.Cognitive Impairment Evaluation and Management[J].Med Clin North Am,2020,104(5):807-825.DOI:10.1016/j.mcna.2020.06.007.
- [28] WALSH E.Cognitive Transformation,Dementia,and the Moral Weight of Advance Directives[J].Am J Bioeth,2020,20(8):54-64.DOI:10.1080/15265161.2020.1781955.
- [29] CHIANG K Y,FAN S Y,CHANG L H,et al.Development and Psychometric Validation of a Tool for Assessing the Care Needs of Families of Patients With Dementia[J].Hu Li Za Zhi,2020,67(4):39-49.Chinese.DOI:10.6224/JN.202008_67(4).06.
- [30] BELTRáN J F,WAHBA B M,HOSE N,et al.Inexpensive,non-invasive biomarkers predict Alzheimer transition using machine learning analysis of the Alzheimer's Disease Neuroimaging (ADNI) database[J].PLoS One,2020,15(7):e0235663.DOI:10.1371/journal.pone.0235663.
- [31] PARK H K,SONG M K,KIM J H,et al.A randomized controlled trial to evaluate the effectiveness and safety of electro acupuncture and transcranial direct current stimulation with computerized cognitive rehabilitation in patients with vascular cognitive impairment[J].Medicine (Baltimore),2020,99(29):e21263.DOI:10.1097/MD.0000000000021263.
- [32] MAEVE L,SHANE M,JOHN M,et al.Comparison of cognitive and neuropsychiatric profiles in hospitalized elderly medical patients with delirium,dementiaand comorbiddelirium-dementia[J].BMJ Open,2016,6(3):9212.DOI:10.1186/s12888-017-1401-4.
- [33] JORDI A,LIUZ R,SARA E L,et al.Treatment Gap for Anxiety Disorders is Global:Results of the World Mental Health Surveys in 21 countries[J].DepressAnxiety,2018,35(3):195-208.DOI:10.1002/14651858.CD011333.pub2.
- [34] HIROAKI K,KENJI Y,HIDEKI K,et al.Differences of Behavioral and Psychological Symptoms of Dementia In Disease Severity in Four Major Dementias[J].PLoS One,2016,11(8):161092.DOI:10.1186/s12877-015-0053-9.
- [35] ALAIND D,SILVIA S,ANGELO C,et al.The Behavioral and Psychological Symptoms of Dementiain Down Syndrome(BPSD-DS)Scale:Comprehensive As sessment of Psychopathology in Down Syndrome[J].J Alzheimers Dis,2018,63(2):797-819.DOI:10.1186/s12955-020-01440-x.
- [36] STEPHANIEV P,SHARMON O,JOHNC M,et al.Neuropsychiatric Symptoms in Dementia:Considerations for Pharmacotherapy in the USA[J].Drugs R D,2019,19(2):93-115.DOI:10.1007/s10654-019-00499-1.