CAJ | 학술논문

目的：观察并比较奥氮平、喹硫平对阿尔茨海默病（ AD）患者睡眠呼吸功能的影响。方法伴有精神行为症状的AD患者随机分组，分别接受奥氮平（n＝42）、喹硫平（n＝38）治疗，疗程6周。治疗前、后行多导睡眠图检查，测定呼吸暂停低通气指数（ AHI）、最低血氧饱和度（ LSaO2）、平均血氧饱和度（ MSaO2）、血氧饱和度＜90％时间占监测总时间的百分比（TS90％）。结果①治疗后，奥氮平组AHI、TS90％增高（分别P＜0．01、0．05），LSaO2、MSaO2降低（均P＜0．05）；喹硫平组变化不显著（P＞0．05）。奥氮平组治疗后的AHI、TS90％显著高于喹硫平组（P＜0．01），LSaO2、MSaO2显著低于喹硫平组（均P＜0．05）。②治疗前，阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）发生率为27．5％（22／80）；治疗后奥氮平组新出现的OSAHS患者比例高于喹硫平组（分别为6／31、0／27，P＜0．05）。③治疗后，两组简易精神状态检查（MMSE）评分无显著变化（均P＞0．05）；而AD病理行为量表（BEHAVE－AD）评分显著降低（P＜0．01）。两组治疗后的MMSE、BEHAVE－AD评分比较差异无统计学意义（P＞0．05）。结论奥氮平对AD患者睡眠呼吸功能可能存在不良影响，而喹硫平的影响不显著。
목적：관찰병비교오담평、규류평대아이자해묵병（ AD）환자수면호흡공능적영향。방법반유정신행위증상적AD환자수궤분조，분별접수오담평（n＝42）、규류평（n＝38）치료，료정6주。치료전、후행다도수면도검사，측정호흡잠정저통기지수（ AHI）、최저혈양포화도（ LSaO2）、평균혈양포화도（ MSaO2）、혈양포화도＜90％시간점감측총시간적백분비（TS90％）。결과①치료후，오담평조AHI、TS90％증고（분별P＜0．01、0．05），LSaO2、MSaO2강저（균P＜0．05）；규류평조변화불현저（P＞0．05）。오담평조치료후적AHI、TS90％현저고우규류평조（P＜0．01），LSaO2、MSaO2현저저우규류평조（균P＜0．05）。②치료전，조새성수면호흡잠정저통기종합정（ OSAHS）발생솔위27．5％（22／80）；치료후오담평조신출현적OSAHS환자비례고우규류평조（분별위6／31、0／27，P＜0．05）。③치료후，량조간역정신상태검사（MMSE）평분무현저변화（균P＞0．05）；이AD병리행위량표（BEHAVE－AD）평분현저강저（P＜0．01）。량조치료후적MMSE、BEHAVE－AD평분비교차이무통계학의의（P＞0．05）。결론오담평대AD환자수면호흡공능가능존재불량영향，이규류평적영향불현저。
Objective To study the effects of olanzapine and quetiapine therapeusis on sleep-breathing in patients with Alzhe-imer'disease ( AD) .Methods AD patients with psychological symptoms were randomly divided into groups that received olanzapine (n=42) and quetiapine (n=38) treatment for 6 weeks.Before treatment, underwent polysomnography examination , determination of apnea hypopnea index (AHI), the lowest oxygen saturation (LSaO2), the average oxygen saturation (MSaO2), blood oxygen satura-tion monitoring <90%time percentage of total time ( TS90%) .Results ①After treatment , AHI and TS90%increased in olanzap-ine group (P<0.01 and 0.05), LSaO2, MSaO2 decreased (all P<0.05).The changes in quetiapine group was not significant (P>0.05).TS90%of Olanzapine group was significantly higher than that of quetiapine group (P<0.01).LSaO2 and MSaO2 were signifi-cantly lower than those of quetiapine group (both P<0.05).②Before pharmacon, 27.5%(22/80) AD subjects were diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS).After pharmacon, more emerging OSAHS patients were surveyed in olanzapine group compared with that in quetiapine group (6/31 vs.0/27, P<0.05).③No significant change (both P>0.05) in scores of min-i-mental state examination (MMSE) and a significant reduced score (both P<0.01) of behavioral pathology in Alzheimer'disease rat-ing scale ( BEHAVE-AD) were found in both two groups at the end of study .There was no difference among the two groups with regard to score of MMSE or BEHAVE-AD after treatment ( both P>0.05 ) .Conclusion Olanzapine therapeutics might do some harmful effects on sleep-breathing in patients with Alzheimer 'disease, while quetiapine therapeutics might do hardly any effects on that .