阿立哌唑对老年痴呆伴精神障碍患者代谢影响及疗效与血药浓度相关性研究

doi:10.19803/j.1672-8629.2021.07.10

中国药物警戒 ›› 2021, Vol. 18 ›› Issue (7): 641-644.
DOI: 10.19803/j.1672-8629.2021.07.10

阿立哌唑对老年痴呆伴精神障碍患者代谢影响及疗效与血药浓度相关性研究

程夏龙, 张许来^*, 吴晓平, 戴彪, 王安珍, 严凡凡

安徽医科大学附属心理医院,安徽省精神卫生中心,合肥市第四人民医院,安徽省精神心理疾病临床研究中心,安徽医科大学第五临床学院,安徽合肥,230022

收稿日期:2020-05-22 出版日期:2021-07-15 发布日期:2021-07-23
通讯作者: ^*张许来,男,硕导·教授,老年心理精神疾病的临床诊治、研究及教学。E-mail：Xulaizhang@ahmhcenter.com
作者简介:程夏龙,男,在读硕士,精神病学,老年心理精神疾病。
基金资助:
国家重点研发计划（2016YFC1305902）; 2018年合肥市科技局“借转补”项目（J2018Y05）

Aripiprazole's Effect on Metabolism in Patients with Behavioral and Psychological Symptoms of Dementia and Correlations between Clinical Efficacy and Blood Concentration

CHENG Xialong, ZHANG Xulai^*, WU Xiaoping, DAI Biao, WANG Anzhen, YAN Fanfan

Affiliated Psychological Hospital of Anhui Medical University, Anhui Mental Health Center, Hefei Fourth People's Hospital, Anhui Clinical Research Center for Mental Disorders, The fifth Clinical College of Anhui Medical University, Hefei Anhui 230022, China

Received:2020-05-22 Online:2021-07-15 Published:2021-07-23

摘要/Abstract

摘要： 目的观察阿立哌唑治疗老年痴呆伴精神障碍（behavioral and psychological symptoms of dementia, BPSD）的疗效和对体重、糖脂代谢的影响,探究阿立哌唑血药浓度与BPSD临床疗效的相关性。方法入组30例BPSD患者给予阿立哌唑抗精神病治疗6周,分别于治疗前及第2、4、6周末进行阿尔茨海默病病理行为量表（BEHAVE-AD）、治疗副反应量表（TESS）评定并测定BMI指数、空腹血糖、胆固醇、甘油三酯、高密度脂蛋白,同时应用高效液相色谱法测定阿立哌唑的血药浓度。结果患者经阿立哌唑治疗6周后BEHAVE-AD评分显著下降（P<0.01）;治疗前后患者BMI指数、空腹血糖、胆固醇、甘油三酯及高密度脂蛋白均无显著性差异;治疗第4周末及第6周末阿立哌唑血药浓度与BEHAVE-AD减分率呈显著正相关,有效组血药浓度显著高于无效组。结论阿立哌唑治疗老年痴呆伴精神障碍的疗效确切,且对患者体重及糖脂代谢影响较小,适用于伴有心脑血管疾病的老年痴呆伴精神障碍患者;阿立哌唑治疗老年痴呆伴精神障碍的血药浓度与临床疗效存在相关性,提示用血药浓度指导治疗更客观,也有利于调整药物剂量,能够为临床合理用药提供依据。

关键词: 老年痴呆伴精神障碍, 阿立哌唑, 临床疗效, 糖脂代谢, 血药浓度

Abstract: Objective To observe the efficacy of aripiprazole in the treatment of behavioral and psychological symptoms of dementia (BPSD) and its effect on BMI, glucose and lipid metabolism, and explore the correlation between the blood concentration of aripiprazole and clinical efficacy. Methods Thirty patients with BPSD were treated with aripiprazole for 6 weeks. BEHAVE-AD and TESS were used for assessment of the efficacy while BMI, fasting blood glucose (FBS), cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL) of the patients were determined. The blood concentration of aripiprazole was determined by HPLC. Results The patients’BEHAVE-AD score decreased significantly after 6 weeks of aripiprazole treatment (P<0.01). BMI, fasting blood glucose, cholesterol, triglyceride, and high-density lipoprotein did not change significantly after treatment. The blood concentrations of aripiprazole at the 4th and 6th weeks of treatment were significantly and positively correlated with the reduction rate of BEHAVE-AD. The blood concentration of the effective group was significantly higher than that of the ineffective group. Conclusion Aripiprazole is effective for BPSD, and has little effect on BMI、glucose or lipid metabolism. It is suitable for patients with cardiovascular and cerebrovascular diseases. There is some correlation between the blood concentration of aripiprazole in the treatment of BPSD and the clinical effect, suggesting that the use of blood concentration as an index can contribute to the efficacy and dose adjustment.

Key words: behavioral and psychological symptoms of dementia, aliprazole, clinical efficacy, glycolipid metabolism, blood drug concentration

中图分类号:

R971.4R969.1

程夏龙, 张许来, 吴晓平, 戴彪, 王安珍, 严凡凡. 阿立哌唑对老年痴呆伴精神障碍患者代谢影响及疗效与血药浓度相关性研究[J]. 中国药物警戒, 2021, 18(7): 641-644.

CHENG Xialong, ZHANG Xulai, WU Xiaoping, DAI Biao, WANG Anzhen, YAN Fanfan. Aripiprazole's Effect on Metabolism in Patients with Behavioral and Psychological Symptoms of Dementia and Correlations between Clinical Efficacy and Blood Concentration[J]. Chinese Journal of Pharmacovigilance, 2021, 18(7): 641-644.

参考文献

[1] Liu YM.The status quo, problems and countermeasures of senile dementia in China[J]. China Social Work(中国社会工作), 2018(14): 28-29
[2] Ge GQ, Wang JJ, Tao K, et al.The burden of behavioral and mental symp-toms of patients with Alzheimer's disease on caregivers[J]. Chinese Journal of Gerontology(中国老年学杂志), 2017, 37(4): 1015-1017.
[3] Zhang WB, Ruan QW, Yao F, et al.Comparison of neuropsychiatric symptoms and caregiver burden between Alzheimer's disease and vascular dementia in the middle and late stages[J]. Alzheimer's Disease and Related Diseases(阿尔茨海默病及相关病), 2019, 2(1): 279-283.
[4] Wu JL.The clinical application of aripiprazole[J]. Medical Inform-ation(医学信息), 2018, 31(14): 42-45.
[5] Wang LS.Effects of antipsychotic aripiprazole orally disintegrating tablets in the treatment of 66 cases of Alzheimer’s disease dementia accompanied by mental and behavioral abnormalities[J]. Bingtuan Medicine(兵团医学), 2014, 41(3): 3-4.
[6] Sheng JH, Chen MJ, Gao ZX, et al.Reliability and validity of Alzheimer's disease pathological behavior scale[J]. Journal of Clinical Psychiatry(临床精神医学杂志), 2001(2): 75-77.
[7] Sun R, Zheng LN, Zhu LL, et al.The status and role of modern analytical techniques in the toxicology of traditional Chinese medicine[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2010, 7(10): 613-616.
[8] Hong SZ, Wu H.The application of modern analytical methods and techniques in pharmaceutical analysis[J]. Anhui Chemical Industry(安徽化工), 2018, 44(1): 3-10.
[9] Hamuro A, Saito S.Five Alzheimer's disease cases with refractory behavioural psychological symptoms of dementia treated with blonanserin[J]. Psychogeriatrics, 2010, 10(4): 198-200.
[10] Testad I, Corbett A, Aarsland D, et al.The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a system-atic review.[J]. International Psychogeriatrics, 2014, 26(7): 198-200.
[11] Li GX, Lin Y, Yao MR.Aripiprazole in the treatment of 51 cases of dementia with mental and behavioral symptoms[J]. Medical Herald(医药导报), 2011, 30(10): 1298-1300.
[12] Jin B, Liu H.Comparative efficacy and safety of therapy for the behavioral and psychological symptoms of dementia: a systemic review and Bayesian network meta-analysis.[J]. Journal of Neurology, 2019, 266(10): 2363-2375.
[13] Yunusa I, Alsumali A, Garba AE, et al.Assessment of reported comparative effectiveness and safety of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia: a network meta-analysis.[j]. jama network open, 2019, 2(3): e190828.
[14] Chen PD, Fang LQ.Study on the effects of aripiprazole and risperidone on behavioral disorders and cognitive function in patients with senile dementia[J]. Shanxi Medical Journal(山西医药杂志), 2017, 46(3): 334-336.
[15] Liao QL, Li Y, Deng HY, et al.A comparative study of olanzapine and aripiprazole in the treatment of mental and behavioral symptoms in patients with senile dementia[J]. Chinese National Health and Medical Sciences(中国民康医学), 2015 (1): 9-11.
[16] Li HT.Comparison of the efficacy and safety of aripiprazole and risperidone in the treatment of mental and behavioral symptoms of dementia[J]. China Continuing Medical Education(中国继续医学教育), 2015, 7(4): 213-214.
[17] Luo KY, Chen F, Zhang H, et al.Effects of atypical antipsychotics on glucose metabolism in patients with mental and behavioral symptoms of dementia[J].Medical Journal of Chinese People's Liberation Army(解放军医药杂志), 2017, 29(11): 89-92.
[18] Sevak RJ, Vansickel AR, Stoops WW, et al.Discriminative-stimulus, subject-rated, and physiological effects of metham-phetamine in humans pretreated with aripiprazole.[J]. Journal of clinical psychopharmacology, 2011, 31(4): 470-480.
[19] Wang ZM, Mi WF, Wang XZ, et al.Efficacy and safety of aripiprazole and quetiapine in the treatment of SchizoPhrenia[J].Chinese Journal of Clinical Pharmacology(中国临床药理学杂志), 2012, 28(12): 941-943.
[20] Zhang F, Wang J.Analysis of the clinical efficacy and quality of life of aripiprazole in the treatment of post-schizophrenia depression[J]. Chinese Journal of Neuromedicine(中华神经医学杂志), 2013, 12(5): 521-524.

阿立哌唑对老年痴呆伴精神障碍患者代谢影响及疗效与血药浓度相关性研究

Aripiprazole's Effect on Metabolism in Patients with Behavioral and Psychological Symptoms of Dementia and Correlations between Clinical Efficacy and Blood Concentration

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	袁琪, 王颖娴, 陈思颖, 尤海生. 1例盐酸厄洛替尼片致严重皮肤溃疡和角膜穿孔的药学监护[J]. 中国药物警戒, 2023, 20(2): 206-208.
[2]	寻晓庆, 彭玲玲. 258例癫痫患儿丙戊酸钠的血药浓度监测及影响因素分析[J]. 中国药物警戒, 2022, 19(9): 1027-1029.
[3]	曹鑫, 崔向丽. 移植患者伏立康唑对免疫抑制剂的浓度及临床结局影响[J]. 中国药物警戒, 2022, 19(2): 193-195.
[4]	朱丽丽, 耿伟, 袁圆, 安晓婕, 袁双丽, 郦昱琨, 陈渤松, 赵军. 他克莫司在儿童肾病中的风险预测模型的建立[J]. 中国药物警戒, 2021, 18(6): 579-583.
[5]	庄红艳, 刘杰, 杜海霞, 鲍爽, 赵燕, 何悦, 果伟. 丙戊酸钠缓释片致喹硫平血药浓度升高1例分析[J]. 中国药物警戒, 2021, 18(10): 986-988.
[6]	连玉菲, 刘洪涛, 任炳楠, 赵海静, 王彦泽, 张玥, 田冬冬, 曹格溪, 岳圆圆, 闫莉. 伏立康唑与奥美拉唑联合应用致伏立康唑超快代谢型患者血药浓度增高的分析[J]. 中国药物警戒, 2020, 17(8): 496-501.
[7]	曾环思, 钟彩妮, 钟易霖, 彭陈陈, 张璇. 129例奥氮平药品不良反应及血药浓度监测临床分析[J]. 中国药物警戒, 2020, 17(11): 818-822.
[8]	杨青, 蔡宁, 袁菱, 孙彬, 金鑫. 1例腹膜透析相关性腹膜炎患者实施万古霉素血药浓度监测的药学实践[J]. 中国药物警戒, 2019, 16(11): 683-687.
[9]	赵飞, 屠继军. 文拉法辛和度洛西汀治疗老年功能性消化不良的临床疗效与安全性的回顾性分析[J]. 中国药物警戒, 2017, 14(7): 399-401.
[10]	卞晓岚, 郑岚. 降脂利肝颗粒联合辛伐他汀治疗非酒精性脂肪肝的临床疗效观察[J]. 中国药物警戒, 2017, 14(2): 71-74.
[11]	盖兴文, 马勇, 张文学. 前列地尔注射液治疗失代偿期乙肝肝硬化的临床观察[J]. 中国药物警戒, 2016, 13(9): 525-528.
[12]	郭雪松, 肖凤. 新生儿万古霉素血药浓度与不良反应分析[J]. 中国药物警戒, 2016, 13(7): 414-416.
[13]	冯静, 郑虎林. 硫辛酸注射液对糖尿病脑梗塞患者疗效及血清炎性因子的影响[J]. 中国药物警戒, 2016, 13(6): 330-332.
[14]	张新建,海鑫,马妍妍,李业雨,郭美华. CMIA法与FPIA法测定癫痫患者血浆中丙戊酸及卡马西平药物浓度的一致性评价[J]. 中国药物警戒, 2016, 13(4): 226-228.
[15]	芮菊萍. 生长抑素、奥美拉唑与凝血酶联合治疗上消化道溃疡性出血的临床观察[J]. 中国药物警戒, 2016, 13(11): 660-662.