阿尔茨海默病淡漠的药物治疗：系统评价与荟萃分析
Pharmacological Therapy for Apathy in Alzheimer's Disease: A Systematic Review and Meta-Analysis.
作者信息
Sepehry Amir A, Sarai Michael, Hsiung Ging-Yuek R
机构信息
1University of British Columbia,Department of Medicine,Division of Neurology,Vancouver,Canada.
2College of Medicine,Kansas City University of Medicine & Biosciences,Kansas City,USA.
出版信息
Can J Neurol Sci. 2017 May;44(3):267-275. doi: 10.1017/cjn.2016.426. Epub 2017 Feb 2.
INTRODUCTION
Apathy is highly prevalent in Alzheimer's disease (AD), but whether pharmacotherapy is effective in managing apathy is unclear.
METHODS
To assess the efficacy of pharmacotherapy for apathy in AD we searched for randomized controlled trials (RCT) and aggregate data reporting on apathy in several search engines, reference lists of articles, and reviews. Demographic characteristics and relevant data were extracted to assess apathy.
RESULTS
Fifteen RCTs' were examined, and 11 were used in aggregate meta-analytic statistics. Drugs included were cholinesterase inhibitors, memantine, and psycho-stimulants. We found no significant treatment effect in favour of any of the drugs, and the effect-size estimates under a random effect model were heterogeneous. Most RCTs had a high attrition rate and used the NPI apathy subscale to measure apathy.
CONCLUSION
The lack of an effect could be explained by methodological limitations, publication bias, and heterogeneity.
引言
冷漠在阿尔茨海默病（AD）中极为常见，但药物治疗对冷漠症状是否有效尚不清楚。
方法
为评估AD中药物治疗对冷漠症状的疗效，我们在多个搜索引擎、文章参考文献列表及综述中搜索随机对照试验（RCT）及关于冷漠症状的汇总数据报告。提取人口统计学特征及相关数据以评估冷漠症状。
结果
共审查了15项RCT，其中11项用于汇总荟萃分析统计。所涉及药物包括胆碱酯酶抑制剂、美金刚和精神兴奋剂。我们发现没有任何一种药物有显著的治疗效果，随机效应模型下的效应量估计具有异质性。大多数RCT的失访率较高，且使用神经精神量表（NPI）的冷漠症状分量表来测量冷漠症状。
结论
疗效缺乏可能是由于方法学局限性、发表偏倚和异质性所致。
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