| 潘晓坤 胡永桃 曾萍 沙红燕 杨娇 黄铭明 朱宏 欧阳松.多奈哌齐治疗阿尔兹海默症患者的临床剂量使用探讨[J].,2016,16(17):3359-3362 |
| 多奈哌齐治疗阿尔兹海默症患者的临床剂量使用探讨 |
| Study on the Dose of Donepezil for Alzheimer's Disease |
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| DOI： |
| 中文关键词: 多奈哌齐 阿尔兹默症 剂量 |
| 英文关键词: Donepezil Alzheimer's disease Dose |
| 基金项目:四川省卫生厅基金项目（scwkj2011-6-008）；国家自然青年科学基金项目（81202730） |
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| 中文摘要: |
| 目的：评价多奈哌齐治疗阿尔兹海默症（AD）的疗效及疗效与用药剂量的关系，探讨检测血清中胰岛素样生长因子-I
（IGF-I）来指导治疗剂量的可行性。方法：87 例轻中度的AD 患者，患者使用5 mg/d 多奈哌齐疗效不佳。在增加剂量之前，根据血
清胰岛素样生长因子-I（IGF-I）水平和简易智力状态检查表（MMSE）得分之间的一致性，将患者分为3 组。A 组：n=27，IGF-I≤ 99
ng/mL，MMSE≤ 37；B组：n=33，IGF-I≤ 99 ng/mL，MMSE>18；C组：n=27，IGF-I>99 ng/mL，MMSE>18。A、B 组中，血清IGF-I水平
显著低于C组。试验开始后将多奈哌齐的剂量从5 mg/d 增加到10 mg/d，服用12 周后，观察血清IGF-I水平同MMSE 和阿尔兹
海默症评定量表（ADAS）得分的相关性及三组患者的临床改善情况。结果：血清IGF-I 水平同认知功能有明显相关性。IGF-I 同
MMSE正相关（r=0.478，P=0.036），IGF-I 同ADAS 得分负相关（r=-0.464，P=0.029）。增加多奈哌齐（10 mg/d）剂量治疗后，只有A
组患者MMSE 得到显著改善。A组患者对治疗的敏感性显著高于B、C 组患者。结论：血清中IGF-I水平和MMSE 分值可以做为
一种标志物，判断对低剂量多奈哌齐（5 mg/d）无效的轻中度AD 患者，能否采用高剂量多奈哌齐（10 mg/d）进行治疗。 |
| 英文摘要: |
| Objective:To evaluate the efficacy of donepezil for Alzheimer's disease (VD) and its correlation with the dose of
donepezil, and to investigate the feasibility of serum insulin-like growth factor-1 (IGF-1) level as a biomarker in guiding dose of
donepezil.Methods:The selected 87 patients with mild AD were non-responders to 5 mg/day-donepezil treatment. Before increasing the
dose, they were divided into 3 groups according to the consistency between the serum levels of IGF-I and MMSE score. Group A: n=27,
IGF-I≤ 99 ng/mL, MMSE≤ 18; group B: n=33, IGF-I≤ 99 ng/ml, MMSE>18; group C: n=27, IGF-I> 99 ng/ml, MMSE>18. In the group
A and B, the plasma level of IGF-I was significantly lower than that of group C. After the start of the test, the dose of donepezil was increased
from 5 mg/day to 10 mg/day, for 12 weeks. Then observe and analyze the correlation of serum IGF-I level with MMSE and
ADAS and the clinical improvement of patients in three groups.Results:There was a correlation between serum IGF-I levels and cognitive
function. IGF-I level was positively correlated with MMSE (r=0.478, P=0.036), but negatively correlated with ADAS (r=-0.464, P=
0.029). After increase of donepezil dose (10 mg/days), only patients in the group A had the MMSE significantly improved. Patients in
group A had significantly higher sensitivity to the treatment than those in group B and C.Conclusion:The level of IGF-I in serum and
MMSE score can be used as markers to predict whether high doses of donepezil (10 mg/days) is effective when low dose (5 mg/day) is
invalid for patients with mild to moderate AD on. |
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