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[阿尔茨海默病的治疗]

[Treatment of Alzheimer's disease].

作者信息

Bombois Stéphanie, Lebert Florence, Vellas Bruno, Pasquier Florence

机构信息

Centre mémoire de ressource et de recherche, EA 2691, CHRU de Lille, 59037 Lille.

出版信息

Rev Prat. 2005 Nov 15;55(17):1913-9.

Abstract

Alzheimer's disease (AD) is a neurodegenerative disorder with a decline in memory and cognitive abilities. During the past 20 years, research on AD has increased the knowledge of the physiopathological mechanisms leading to the disease. The major hallmarks of AD are amyloid plaques and neurofibrillary tangles, associated with a prevalent and early cholinergic deficit and an excitotoxicity with inflammation. These pathological mechanisms represent current and future therapeutic targets. cholinesterase inhibitors were the first therapeutic class that has consistently shown a clinical efficacy and safety in patients with mild to moderate ad. more recently glutamate receptor antagonists have been shown effective in the management of patients with moderate to severe AD. These two therapeutic classes could improve cognitive functions, slow the progression of the cognitive decline, prevent some behavioural changes and delay institutionalisation. However, AD represents a problem of public health and preventive and curative strategies have to be proposed.

摘要

阿尔茨海默病(AD)是一种导致记忆和认知能力衰退的神经退行性疾病。在过去20年里,对AD的研究增进了我们对导致该疾病的生理病理机制的了解。AD的主要特征是淀粉样斑块和神经原纤维缠结,伴有普遍且早期的胆碱能缺陷以及伴有炎症的兴奋性毒性。这些病理机制是当前和未来的治疗靶点。胆碱酯酶抑制剂是首个在轻度至中度AD患者中始终显示出临床疗效和安全性的治疗类别。最近,谷氨酸受体拮抗剂已被证明对中重度AD患者的治疗有效。这两类治疗方法可以改善认知功能,减缓认知衰退的进程,预防一些行为变化并延迟送入养老院。然而,AD是一个公共卫生问题,必须提出预防和治疗策略。

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