CAJ | 학술논문

目的观察多奈哌齐治疗阿尔茨海默病(AD)的远期疗效和安全性. 方法 86例AD患者随机分为对照组43例和治疗组43例.对照组运用茴拉西坦、尼莫地平、银杏叶片进行常规治疗,治疗组在常规治疗的基础上每日加服多奈哌齐l0 mg.以简易智能状态检查量表(MMSE)、AD评估量表认知分量表(ADAS-cog)、日常生活能力量表(ADL)、总体衰退量表(GDS)等评分作为主要评价指标,比较两组患者在治疗前与治疗3、6、12、18、24、30、36、42、48、54、60、66和72个月后的认知能力、精神状况、日常生活能力的情况. 结果与对照组比较,治疗组患者MMSE、ADAS-cog、GDS评分在3个月以后、ADL评分在6个月以后优于对照组,差异有统计学意义(t=2.361,-2.198,-1.790和-2.420;P＜0.05或P＜0.01)；12个月时与对照组相比最显著(均P＜0.01),36个月以后各项指标继续减退,到72个月时,治疗组与对照组相比,MMSE高出7.5分,ADAS-cog优于20.3分,ADL优于19.5分,GDS优于1.4分(均P＜0.01).与治疗前比较,治疗组患者MMSE、ADAS cog、GDS评分在治疗3、6、12、18和24个月时差异有统计学意义(P＜0.05或P＜0.01)；ADL评分在6、12、18、24和30个月时差异有统计学意义(P＜0.05或P＜0.01)；ADAS-cog和GDS评分在24个月以后、MMSE和ADL在30个月以后差异无统计学意义(P＞0.05). 结论多奈哌齐治疗AD的远期疗效满意,安全可靠,可有效减缓AD患者认知功能和总体功能衰退进程.
목적 관찰다내고제치료아이자해묵병(AD)적원기료효화안전성. 방법 86례AD환자수궤분위대조조43례화치료조43례.대조조운용회랍서탄、니막지평、은행협편진행상규치료,치료조재상규치료적기출상매일가복다내고제l0 mg.이간역지능상태검사량표(MMSE)、AD평고량표인지분량표(ADAS-cog)、일상생활능역량표(ADL)、총체쇠퇴량표(GDS)등평분작위주요평개지표,비교량조환자재치료전여치료3、6、12、18、24、30、36、42、48、54、60、66화72개월후적인지능력、정신상황、일상생활능력적정황. 결과 여대조조비교,치료조환자MMSE、ADAS-cog、GDS평분재3개월이후、ADL평분재6개월이후우우대조조,차이유통계학의의(t=2.361,-2.198,-1.790화-2.420;P＜0.05혹P＜0.01)；12개월시여대조조상비최현저(균P＜0.01),36개월이후각항지표계속감퇴,도72개월시,치료조여대조조상비,MMSE고출7.5분,ADAS-cog우우20.3분,ADL우우19.5분,GDS우우1.4분(균P＜0.01).여치료전비교,치료조환자MMSE、ADAS cog、GDS평분재치료3、6、12、18화24개월시차이유통계학의의(P＜0.05혹P＜0.01)；ADL평분재6、12、18、24화30개월시차이유통계학의의(P＜0.05혹P＜0.01)；ADAS-cog화GDS평분재24개월이후、MMSE화ADL재30개월이후차이무통계학의의(P＞0.05). 결론 다내고제치료AD적원기료효만의,안전가고,가유효감완AD환자인지공능화총체공능쇠퇴진정.
Objective To evaluate the long-term efficacy and safety of donepezil in treating patients with Alzheimer's disease(AD).Methods Totally 86 patients with AD were randomly divided into control group(n =43)and treatment group(n =43).The control grou,p received conventional therapy with aniracetam,nimoldipine and ginkgo tablet,while the study group was administrated with donepezil(10 mg/d)on the basis of conventional therapy.The improvements of recognitive ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),Alzheimer's disease assessment scale-cog(ADAS-cog),activity of daily living(ADL)and global deterioration scale(GDS).The scores were compared between the groups before the treatment and 3,6,12,18,24,30,36,42,48,54,60,66 and 72 months after the treatment,respectively.Results The scores of MMSE,ADAS-cog and GDS after 3 months and ADL score after 6 months (t=2.361,-2.198,-1.790,-2.420,P＜0.05 or P＜0.01)were improved in treatment group than in control group with the best effects at 12 months(all P＜0.01)and the scores continued to decrease after 36 months.At 72 months,the score improvements in treatment group were 7.5 for MMSE,20.3 for ADAS-cog,19.5 for ADL,and 1.4 for GDS as compared with control group(all P ＜0.01).In contrast to pretreatment,there were statistically significant differences in the scores of MMSE,ADAS-cog and GDS at 3,6,12,18 and 24 months,and in the score of ADL at 6,12,18,24 and 30 months after treatment(P＜0.05 or P＜0.01).The differences in the scores of ADAS-cog and GDS after 24 months as well as MMSE and ADL after 30 months were not found(P＞0.05)between pre-treatment and post-treatment.Conclusions Donepezil might be long term effective and safe in slowing down the recognitive and overall function deterioration of AD.