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目的 观察西酞普兰治疗阿尔茨海默病(Alzheimer’s disease,AD)患者的精神行为症状、认知障碍的疗效和安全性.方法 从2015年4月至2016年2月在青岛市精神卫生中心收集80例中度AD(根据临床痴呆评定量表,CDR)并伴有精神行为症状的患者,将其随机分为治疗组和对照组,每组各40例.治疗组给予西酞普兰10~30 mg/d治疗,对照组给予同剂量的安慰剂,两组均口服美金刚10 mg bid,疗程12周.用简易精神状态检查(MMSE)测量认知功能,神经精神科问卷(NPI)测量BPSD,以及副反应量表(TESS)评定有无不良反应,比较两组患者的疗效和安全.结果 治疗组和对照组经12周治疗后,两组减分值分别(0.67±0.77)分和(0.26±0.68)分,两组减分值相比较,差异有统计学意义(t=2.49,P=0.02);治疗组和对照组经过12周治疗后在 NPI量表中激越/攻击(t=2.986,P=0.04)、情感淡漠/漠不关心(t=3.144,P=0.002)、抑郁/心境恶劣(t=6.094,P=0.000)和焦虑(t=6.496,P=0.000)四个方面差异有统计学意义,最常见的不良反应为头晕、头痛、疲乏、恶心,治疗组在西酞普兰剂量为30 mg/d时出现QTc间期延长,TESS量表未见明显差异.结论 西酞普兰联合美金刚治疗中度AD,可以改善精神行为症状,尤其是激越/攻击、情感淡漠/漠不关心、抑郁/心境恶劣和焦虑方面,认知功能也可改善,安全性高,不良反应小.“,”Objective To observe the efficacy and safety of citalopram in the treatment of behav-ioural and psychological symptoms of dementia(BPSD)and cognitive function of Alzheimer’s disease(AD) patients.Methods From April 2015 to February 2016,80 cases of moderate Alzheimer’s disease(according to the clinical dementia rating scale,CDR)with symptoms of BPSD in Qingdao Mental Health Center were collected and randomly divided into treatment group and control group.Treatment group was given citalopram (10 to 30 mg/d),the control group was given the same dose of placebo,and the patients in both group were given memantine(10 mg/bid)for 12 weeks.Simple mental state examination(MMSE)was used to measure cognitive function.Neural psychiatric questionnaire(NPI)measurement was used to evaluate BPSD and the TESS was used to assess adverse effects.Results Decreased scores of MMSE between the treatment group and the control group were respectively(0.67±0.77)and(0.26±0.68)after 12 weeks of treatment.There was significant difference in decreased scores of MMSE between the two groups(t=2.49,P=0.02).The scores of NPI in agitation/attack(t=2.986,P=0.04),apathy(t=3.144,P=0.002),indifference/dysthymia (t=6.094,P=0.000)and anxiety(t=6.496,P=0.000)showed statistically significant differences between the two groups.There were no significant difference in TESS scores(P>0.05).The most frequently adverse e-vents in the study included dizziness,headache,fatigue and nausea.QTc interval prolongation were found in participants treated with 30 mg citalopram per day in the study group.Conclusion Citalopram is an effec-tive and safe drug in the treatment of BPSD and cognitive function associated with moderate AD.