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当代阿耳茨海默病研究

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ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

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Meta-Analysis

基于剂量的胆碱酯酶抑制剂和美金刚对血管性认知障碍患者的疗效和可接受性的比较：网络meta-分析

卷 19, 期 2, 2022

发表于: 08 March, 2022

页: [133 - 145] 页: 13

弟呕挨: 10.2174/1567205019666220120112301

价格: $65

摘要

背景：考虑到缺乏血管性认知障碍（VCI）患者胆碱酯酶抑制剂和美金刚之间的直接比较，确定如何选择最佳治疗方案仍没有定论。因此，我们进行了网络meta-分析，比较这些药物的疗效和可接受性。 方法：从数据库开始到2020年1月1日，PubMed、Cochrane中央对照试验登记册、Embase和Web of Science进行了对VCI治疗方法的双盲随机对照试验（RCT），其中涉及到多奈哌齐、加兰他敏、利斯的明和美金刚。然后，以频率方法为基础进行了网络meta-分析。 结果：共包括11个RCT。与安慰剂相比，在疗效方面，多奈哌齐5mg（标准化平均差=-1.11，95%置信区间=-1.88至-0.34）、多奈哌齐10mg（-1.44、-2.31至-0.56）、加兰他敏24mg（-1.99、-3.03至-0.95）和美金刚20mg（-1.89、-2.93至-0.86）对ADAS-cog的认知功能更加有效，多奈哌齐5mg（0.46、0.12至0.81）、多奈哌齐10mg（0.76、0.34至1.17）和利斯的明12mg（0.60、0.10至1.10）对MMSE的认知功能更有益。多奈哌齐10mg（-0.25，-0.44至-0.06；-1.47，-2.79至-0.15）分别对CDR-SB和EXIT25有所改善。在可接受性方面，美金刚是最佳的。 结论：多奈哌齐5mg、多奈哌齐10mg、加兰他敏24mg、美金刚20mg和利斯的明12mg对认知有好处，多奈哌齐10mg对执行功能和全球地位有好处。基于网络meta-分析，考虑到认知功能、执行功能和全球地位的益处，多奈哌齐10mg可能是最佳选择，但需要注意剂量引起的不良反应。同时，在疗效和安全性方面，美金刚是一个更好的综合性选择。

关键词: 血管性认知障碍VCI，血管痴呆症（VD），胆碱酯酶抑制剂（ChEIs），美金刚，网络meta-分析，安慰剂

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