喹硫平联合吡拉西坦治疗老年痴呆伴痴呆的行为和精神症状的疗效及对认知功能的影响

Efficacy of Quetiapine Combined with Piracetam in the Treatment of Elderly Patients with Dementia and BPSD and Its Impact on Cognitive Function

摘要

目的 探讨喹硫平联合吡拉西坦治疗老年痴呆伴痴呆的行为和精神症状（behavioral and psychological symptoms of dementia，BPSD）患者的疗效及对认知功能的影响。方法 回顾性选取2021年1月至2024年2月舟山市第二人民医院收治的老年痴呆伴BPSD患者98例，根据治疗方案不同分为2组，对照组49例予以喹硫平治疗，观察组49例予以喹硫平联合吡拉西坦治疗。治疗后比较2组临床疗效、血清泌乳素、血脂水平、简明精神病评定量表（Brief Psychiatric Rating Scale，BPRS）评分、简易智能精神状态检查表（Mini-Mental State Examination，MMSE）评分、社会功能缺陷筛选量表（Social Disability Screening Schedule，SDSS）评分及不良反应发生率。结果 观察组临床总有效率显著高于对照组（P < 0.05）；观察组治疗后BPRS评分、SDSS评分及血清泌乳素水平显著低于对照组，MMSE评分以及高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C）水平显著高于对照组（P < 0.05）；2组治疗后甘油三酯（triglyceride，TG）、总胆固醇（total cholesterol，TC）及低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）水平及不良反应总发生率比较差异无统计学意义（P > 0.05）。结论 喹硫平联合吡拉西坦治疗老年痴呆伴BPSD患者疗效明显，其认知功能和社会功能得到改善，对泌乳素水平影响小。

Abstract

Objective To evaluate the efficacy of quetiapine combined with piracetam in the treatment of elderly patients with dementia and behavioral and psychological symptoms of dementia (BPSD), and its impact on cognitive function. Methods A retrospective analysis was conducted on 98 elderly patients with dementia and BPSD admitted to Zhoushan Second People,s Hospital from January 2021 to February 2024. Patients were divided into two groups according to different treatment regimens: the control group (49 cases) received quetiapine alone, while the observation group (49 cases) received quetiapine combined with piracetam. After treatment, clinical efficacy, serum prolactin and lipid levels, Brief Psychiatric Rating Scale (BPRS) scores, Mini-Mental State Examination (MMSE) scores, Social Disability Screening Schedule (SDSS) scores, and the incidence of adverse reactions were compared between the two groups.Results The overall clinical response rate in the observation group was significantly higher than that in the control group (P < 0.05). After treatment, the observation group showed significantly lower BPRS and SDSS scores and serum prolactin levels, as well as significantly higher MMSE scores and high-density lipoprotein cholesterol (HDL-C) levels compared to the control group (P < 0.05). No statistically significant differences were observed between the two groups in the levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), or the overall incidence of adverse reactions after treatment (P > 0.05). Conclusion The combination of quetiapine and piracetam demonstrates notable therapeutic efficacy in elderly patients with dementia and BPSD, with improvements in cognitive and social functioning and a minimal impact on prolactin levels.

关键词

喹硫平 / 吡拉西坦 / 老年痴呆 / 痴呆的行为和精神症状 / 泌乳素 / 认知功能

Key words

quetiapine / piracetam / elderly dementia / behavioral and psychological symptoms of dementia / prolactin / cognitive function

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基金资助

舟山科技计划项目(2024C31022)