【摘要】

摘要 目的 探讨不同剂量多奈哌齐对阿尔茨海默症（AD）患者的认知功能与血清胰岛素样生长因子-I（IGF-I）水平的影响。
方法 选取我院于2016年9月~2017年8月收治的AD患者96例为研究对象。按照随机数字表法分为低剂量组、中剂量组、高剂量组三组，每组各32例。低剂量组给予口服2.5mg多奈哌齐，中剂量组给予口服5.0mg多奈哌齐，高剂量组给予口服10.0mg多奈哌齐。比较三组患者治疗前、治疗后3个月、6个月、9个月的简易精神状态量表（MMSE）、阿尔茨海默病评定量表认知分量表（ADAS-cog）量表及血清IGF-I水平。
结果 低剂量组MMSE量表评分、ADAS-cog量表评分 、IGF-I水平治疗前与治疗后3个月至治疗后9个月比较差异无统计学意义（P>0.05）。中剂量组与高剂量组MMSE量表评分、ADAS-cog量表评分 、IGF-I水平治疗后6个月、治疗后9个月与治疗前比较差异均有统计学意义（P＜0.05）；且高剂量组治疗后6个月、治疗后9个月MMSE量表评分、IGF-I水平高于中剂量组，而ADAS-cog量表评分低于中剂量组 ，差异有统计学意义（P＜0.05）。
结论 多奈哌齐可显著改善AD患者认知功能、日常生活能力和提升血清IGF-I水平，且存在剂量相关效应，高剂量多奈哌齐疗效更佳。

【Abstract】

Abstract Objective To investigate the effects of different doses of donepezil on cognitive function and Serum insulin like growth factor -I (IGF-I) in patients with Alzheimer's disease (AD).
Methods 96 patients with AD admitted to our hospital from September 2016 to August 2017 were selected as the subjects.The patients were divided into three groups:low dose group,medium dose group and high dose group,32 cases in each group.The low-dose group received oral 2.5mg donepezil,the middle dose group received oral 5.0mg donepezil,high dose group received oral 10.0mg donepezil.The Mini Mental State Scale (MMSE),the Alzheimer's disease Assessment Scale-cognitive Subscale scale (ADAS-cog) and serum IGF-I level were compared between the three groups before treatment,3 months,6 months and 9 months after treatment.
Results The MMSE scale score,ADAS-cog scale score and IGF-I level in the low dose group before treatment were not significantly different from those of 3 months to 9 months after treatment (P>0.05).There were statistically significant differences in MMSE scale score,ADAS-cog scale score,IGF-I level in the middle dose group and the high dose group at 6 months and 9 months after treatment (P < 0.05).The scores of MMSE scale and IGF-I levels in the high dose group at 6 months and 9 months after treatment were higher than those in the middle dose group,the ADAS-cog scale score was lower than that of the middle dose group,the differences were statistically significant (P < 0.05).
Conclusion   Donepezil can significantly improve cognitive function,daily living ability and serum IGF-I level in patients with AD,there was dose related effect, and high dose donepezil had better curative effect.