乙酰胆碱酯酶抑制剂对阿尔茨海默病患者临床反应及脑血流变化的差异效应：一项为期12个月的随机开放标签试验。
Differential effects of acetylcholinesterase inhibitors on clinical responses and cerebral blood flow changes in patients with Alzheimer's disease: a 12-month, randomized, and open-label trial.
作者信息
Shimizu Soichiro, Kanetaka Hidekazu, Hirose Daisuke, Sakurai Hirohumi, Hanyu Haruo
机构信息
Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
出版信息
Dement Geriatr Cogn Dis Extra. 2015 Apr 10;5(1):135-46. doi: 10.1159/000375527. eCollection 2015 Jan-Apr.
BACKGROUND/AIMS: The present study evaluated the differences in treatment outcomes and brain perfusion changes among 3 types of acetylcholinesterase inhibitors (AchEIs, i.e. donepezil, rivastigmine, and galantamine).
METHODS
This was a prospective, longitudinal, randomized, open-label, 3-arm (donepezil, rivastigmine, or galantamine), parallel-group, 12-month clinical trial carried out in 55 patients with AD.
RESULTS
At 6 months, the results of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT)-Part A showed an improvement versus baseline in the donepezil treatment group. All groups showed a significant increase in regional cerebral blood flow (rCBF), mainly in the frontal lobe. Significant rCBF reduction was observed in the temporal lobe and cingulate gyrus in all 3 groups.
CONCLUSION
AchEI treatment prevents the progression of cognitive impairment and increases the relative rCBF in the frontal lobe.
背景/目的：本研究评估了3种乙酰胆碱酯酶抑制剂（AChEIs，即多奈哌齐、卡巴拉汀和加兰他敏）在治疗效果和脑灌注变化方面的差异。
方法
这是一项前瞻性、纵向、随机、开放标签、三臂（多奈哌齐、卡巴拉汀或加兰他敏）、平行组、为期12个月的临床试验，共纳入55例阿尔茨海默病患者。
结果
在6个月时，多奈哌齐治疗组的简易精神状态检查表（MMSE）和连线测验（TMT）-A部分结果与基线相比有所改善。所有组的局部脑血流量（rCBF）均显著增加，主要在额叶。在所有3组中，颞叶和扣带回均观察到rCBF显著降低。
结论
AChEI治疗可预防认知障碍的进展，并增加额叶的相对rCBF。
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