|本期目录/Table of Contents|

[1]林小燕,邱 静,王 锐,等.奥氮平、喹硫平对阿尔茨海默病患者睡眠呼吸的影响[J].医学研究与战创伤救治(原医学研究生学报),2015,17(01):8-11.[doi:10.3969/j.issn.1672-271X.2015.01.003]
　LIN Xiao-yan,QIU Jing,WANG Rui,et al.Effects of olanzapine and quetiapine on sleep-breathing in patients with Alzheimer disease[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(01):8-11.[doi:10.3969/j.issn.1672-271X.2015.01.003]
点击复制

奥氮平、喹硫平对阿尔茨海默病患者睡眠呼吸的影响()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年01期
页码:
8-11
栏目:
出版日期:
2015-01-31

文章信息/Info

Title:
Effects of olanzapine and quetiapine on sleep-breathing in patients with Alzheimer disease
作者:
林小燕1; 邱 静1; 王 锐1; 阎同军2; 王 莹1; 江景娟2
213003 江苏常州，解放军102医院，1.内一科，2.精神科
Author(s):
LIN Xiao-yan1;  QIU Jing1;  WANG Rui1;  YAN Tong-jun2;  WANG Ying1;  JIANG Jing-juan2．
1.Department of Internal Medicine， 2．Department of Psychiatry， 102 Hospital of PLA， Changzhou， Jiangsu 213003， China
关键词:
阿尔茨海默病; 睡眠呼吸障碍; 奥氮平; 喹硫平; 多导睡眠图
Keywords:
Alzheimer’ disease;  sleep-breathing disorde;  olanzapine;  quetiapine;  polysomnograph
分类号:
R563.8
DOI:
10.3969/j.issn.1672-271X.2015.01.003
文献标志码:
A
摘要:
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。
Abstract:
Objective To study the effects of olanzapine and quetiapine therapeusis on sleep-breathing in patients with Alzheimer 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 saturation monitoring < 90% time percentage of total time (TS90%). Results ①After treatment， AHI and TS90% increased in olanzapine 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 significantly 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 mini-mental state examination (MMSE) and a significant reduced score (both P<0.01) of behavioral pathology in Alzheimer disease rating 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.

参考文献/References:

［1］Cooke JR，Liu L，Natarajan L，et al．The effect of sleep-disorderedbreathing on stages of sleep in patients with Alzheimersdisease［J］．Behav Sleep Med，2006，4(2):2l9-227.
［2］陈翠婷，石祥秋，张维珍，等.特殊群体发生老年痴呆症的日常生活影响因素调查分析［J］．东南国防医药，2014，16(2):171-173.
［3］尹昌浩，郭艳芹，韩 璎.轻度认知障碍的研究进展［J］．医学研究生学报，2012，25(9):977-979.
［4］Gottlieb DJ，Yenokyan G，Newman AB，et al．Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure:the sleep heart health study［J］．Circulation，2010，122(2):352-360．
［5］Lal C，Strange C，Bachman D．Neurocognitive impairment in obstructive sleep apnea［J］．Chest，2012，141(6):1601-1610．
［6］Bishara D，Taylor D，Howard RJ，et al．Expert opinion on the management of behavioral and psychological symptoms of dementia(BPSD) and investigation into prescribing practices in the UK［J］．Int J Geriatr Psychiatry，2009，24(7):944-954．
［7］王效敏，田少华.痴呆在综合医院住院患者中的临床特点［J］．中国老年医学杂志，2010，30(12):1716-1717.
［8］Sect E，Chung F．Obstructive sleep apnea:preoperative assessment［J］．Anesthesiol Clin，2010，28(2):199-215.
［9］中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)［J］．中华结核和呼吸杂志，2012，35(1):9-12．
［10］林其昌，黄建钗，丁海波，等．福州市区老年人阻塞性睡眠呼吸暂停低通气综合征流行病学调查［J］．中华老年医学杂志，2010，29(4):332-335.
［11］Gehrman PR，Martin JL，Shochat T，et al．Sleep-disordered breathing and agitation in institutionalized adults with Alzheimer disease［J］．Am J Geriatr Psychiatry，2003，11(4):426-433．
［12］Bartlett DJ，Rac C，Thompson CH，et al．Hippocampal area metabolites relate to severity and cognitive function in obstructive sleep apnea ［J］．Sleep Med，2004，5(6):593-596.
［13］Ancoli-Israel S，Ayalon L．Diagnosis and treatment of sleep Disorders in older adults［J］．Am J Geriatr Psychiatry，2006，14(2):95-103.
［14］Eikermann M，Jordan AS，Chamberlin NL，et al．The influence of aging on pharyngeal collapsibility during sleep［J］．Chest，2007，131(6):1702-1710．
［15］Onen F，Onen H．Obstructive sleep apnea and cognitive impairment in theelderly［J］．Psychol Neuropsychiatr Vieil，2010，8(2):163-169．
［16］赵蒙蒙，张希龙.阻塞性睡眠呼吸暂停低通气综合征的诊断与治疗［J］．中华医学杂志，2012，92(12):1228-1230．
［17］李进让，孙建军，章 榕，等.TS90％评估阻塞性睡眠呼吸暂停低通气综合征低氧血症程度的临床价值［J］．中华医学杂志，2005，85(44):3115-3117.
［18］王俊清，许崇涛，江丽云，等.首发精神分裂症患者睡眠特征及奥氮平对体质量、睡眠呼吸的影响［J］．中华行为医学与脑科学杂志，2012，21(11):997-999.
［19］Sharafkhaneh A，Giray N，Richardson P，et al．Association of psychiatric disorders and sleep apnea in a large cohort［J］．Sleep，2005，28(10):1405-1411.
［20］居建平，周建新，王佩芳，等.奥氮平治疗慢性阻塞性肺病呼吸衰竭伴精神兴奋症状临床分析［J］．实用临床医药杂志，2012，16(17):102-103.
［21］方亚明，周云飞，刘彦颖.喹硫平与奥氮平治疗血管性痴呆精神行为症状的对照研究［J］．临床精神医学杂志，2010，20(4):249-251.
［22］Tso HH，Lee JS，Huang JC，et al．Evaluation of the human airway using cone-beam computerized tomography［J］．Oral Surg Oral Med Oral Pathol Oral Radiol Endod，2009，108(5):768-776．
［23］Martinez-Gonzalez JM，Martinez-Rodriguez N，Arias-Irimia O，et al．Odontostomatological therapeutic possibilities in patients with sleep apnea［J］．Med Oral Patol Oral Cir Bucal，2010，15(4):e605-e610.
［24］Yin G，Ye J，Han D，et al．Association of the 5-HT2A receptorgene polymorphisms with obstructive sleep apnea hypopneasyndrome in Chinese Han population［J］．Acta Otolaryngol，2012，132(2):203-209.
［25］Carley DW，Olopade C，Seink S，et al．Serotonin antagonist improves obstructive sleep apnea［J］．Sleep Med，2003(Suppl 4):20-24．

相似文献/References:

[1]段立晖,周国庆,孙芳,等.β-淀粉样蛋白对大鼠学习记忆、病理[J].医学研究与战创伤救治(原医学研究生学报),2009,11(05):389.
　DUAN Li-hui,ZHOU Guo-qing,SUN Fang,et al.The influence of beta-amyloid on learning and memory, histologic changes and tau hyperphosphorylation in rats[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(01):389.

备注/Memo

备注/Memo:
全军医药卫生科研基金面上项目(MS020)
更新日期/Last Update: 2015-01-20