伊帅 于笑峰

[摘要] 目的 分析和研究奥氮平治疗老年痴呆伴发精神行为障碍的临床疗效。方法 方便该院在2015年5月—2017年5月期间收治的136例老年痴呆伴发精神行为障碍的患者作为研究对象，按照患者入院单号单双将其分为参照组和研究组，各68例，其中参照组患者采用利培酮治疗，研究组患者采用奥氮平治疗，观察和比较两组患者的临床疗效、不良反应发生情况以及阿尔兹海默病病理评分。结果 参照组患者的治疗总有效率和不良反应发生率分别为91.18%、22.06%，研究组患者的治疗总有效率和不良反應发生率分别为94.12%、7.35%，由此可见，研究组患者治疗有效率略高于参照组，差异无统计学意义（χ2=1.003 5，P=0.06 >0.05）；研究组患者的不良反应发生率要显著低于参照组（χ2=7.065 1，P=0.01），且研究组患者的阿尔兹海默病病理行为也得到明显改善，差异有统计学意义（P<0.05）。 结论 采用奥氮平治疗老年痴呆伴发精神行为障碍，患者的临床症状能够得到有效改善，且安全性更高，在临床中值得推广。

[关键词] 老年痴呆；伴发精神行为障碍；利培酮；奥氮平；临床疗效

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0007-03

The Clinical Analysis of Olanzapine in the Treatment of Senile Dementia with Psychiatric Behavior Disorder

YI Shuai， YU Xiao-feng

Department of Neurology， Qingdao No.8 Peoples Hospital， Qingdao， Shandong Province， 266000 China

[Abstract] Objective This paper tries to analyze and study the clinical efficacy of olanzapine in the treatment of dementia with senile dementia. Methods 136 cases of senile dementia patients with comorbid mental behavior disorder from May 2015 to May 2017 were convenient selected as the research objects， according to the patients admission order， i.e. single and double number， they were divided into control group and the study group， with 68 cases in each group， the control group was treated by risperidone treatment， treatment group was treated by olanzapine， to observe and compare the clinical efficacy of two groups of patients， adverse reactions， and alzheimer's disease pathology score. Results The treatment of patients with the control group of the total effective rate and the incidence of adverse reactions were 91.18%， 22.06%， and those of the study group of total effective rate and the incidence of adverse reactions were 94.12% and 7.35% respectively， thus， the stuey group was slightly higher than that of control group without statistically significant difference（χ2=1.003 5， P=0.06 >0.05）； the incidence of adverse reactions was significantly lower than that of control group（χ2=7.065 1， P=0.01）， and the alzheimer's disease pathological behavior had also been improved significantly， the difference was statistically significant（P<0.05）. Conclusion The clinical symptoms of olanzapine in the treatment of senile dementia with mental disorders can be improved effectively， and the safety is higher， which is worth promoting in clinic.

[Key words] Alzheimers disease； Mental and behavioral disorders； Risperidone； Olanzapine； Clinical Efficacy

在近几年，社会老龄化现象已经我国的一种社会级现象，国家政府以及社会大众都越来越关注这一方面的问题，其中以老年群体为高发人群的疾病发病率也呈逐年增长趋势，因而在老年痴呆症患者人数逐年增加。老年痴呆患者不仅仅会出现智能下降问题，同时还会表现为妄想、幻觉、攻击性、行为紊乱等精神疾病方面的症状，这样在治疗的过程中就需要适当的应用抗精神类药物[1]。但如果长期使用这类药物的话，会导致患者意识障碍问题进一步加重，出现严重的椎体外系不良反应，同时患者的认知功能也会受到一定程度的影响，降低治疗及预后效果。该……