严志聪

[摘要] 目的 探讨盐酸美金刚改善帕金森病痴呆患者认知功能及日常生活能力的效果。 方法 选取本院2013年9月～2015年9月收治的69例帕金森病痴呆患者作为研究对象，随机分为对照组（n=34）与观察组（n=35）。对照组给予盐酸多奈哌齐治疗，观察组给予盐酸美金刚治疗。比较两组的认知功能、日常生活能力及药物不良反应发生率。 结果 观察组治疗后8、16周的MoCA评分及MMSE评分显著高于对照组，差异有统计学意义（P<0.05）。观察组的日常生活能力优良率为80.0%，显著高于对照组的55.9%，差异有统计学意义（P<0.05）。观察组的不良反应发生率显著低于对照组，差异有统计学意义（P<0.05）。 结论 盐酸美金刚治疗帕金森病痴呆具有较好的临床效果，能够有效改善患者的认知水平及生活能力，不良反应发生率低，值得临床推广应用。

[关键词] 盐酸美金刚；帕金森病；痴呆；认知；日常生活能力

[中图分类号] R742.5 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0097-03

[Abstract] Onjective To explore the effect of memantine hydrochloride in improving cognitive function and ability of daily life of Parkinson disease patients with dementia. Methods 69 Parkinson disease patients with dementia from September 2013 to September 2015 in our hospital were selected and randomly divided into the control group （n=34） and the observation group （n=35）.The control group was treated with donepezil hydrochloride，the observation group was treated with memantine hydrochloride.The cognitive function，ability of daily life and the incidence rate of adverse reaction in the two groups was compared. Results The score of MoCA and MMSE after treatment for 8 and 16 weeks in the observation group was higher than that in the control group，with significant difference （P<0.05）.The excellent and good rate of ability of daily life in the observation group was 80.0%，which was higher than 55.9% in the control group，with significant difference （P<0.05）.The incidence rate of adverse reaction in the observation group was lower than that in the control group，with significant difference （P<0.05）. Conclusion Memantine hydrochloride in the treatment of Parkinson disease and dementia has good clinical effect，which can obviously improve the cognitive function and ability of daily life of patients，and the incidence rate of adverse reaction is low，it is worthy of clinical promotion and application.

[Key words] Memantine hydrochloride；Parkinson disease；Dementia；Cognition；Ability of daily life

帕金森病是神经内科常见的神经退行性病变疾病之一，患者中脑存在黑质多巴胺变性、缺失或变性神经元内存在路易小体[1-2]。帕金森病患者存在运动功能障碍，随着病情发展，还会出现性格改变、认知功能减退，进而导致生活能力与生存质量下降[3]。研究显示[4]，约30%的帕金森病患者合并痴呆，成为帕金森病痴呆，且帕金森病患者患痴呆的风险是正常人的4～6倍。盐酸美金刚作为新型的N-甲基-D-天冬氨酸受体拮抗剂，对于帕金森患者痴呆症状有较好的改善效果[5]。本研究旨在观察盐酸美金刚对帕金森病痴呆患者的影响。

1 资料与方法

1.1 一般资料

选取本院2013年9月～2015年9月收治的69例帕金森病痴呆患者作为研究对象，纳入标准：①符合帕金森病痴呆诊断标准[6]；②排除各种神经系统疾病如脑卒中、血管性痴呆、颅脑损伤等引起的痴呆；③排除抗帕金森病药物使用禁忌者；④排除不愿签署研究知情同意书者。……