摘要
目的:血管性痴呆患者血浆和脑脊液中精氨酸加压素水平与神经递质传递及学习记忆功能活动有关,了解川芎嗪治疗后血管性痴呆患者认知功能与精氨酸加压素水平的关系,并以银杏叶提取物作标准对照。方法:选择2000-01/2003-12辽宁省庄河市中心医院神经内科收治的血管性痴呆患者100例,随机分为川芎嗪组和银杏叶提取物组,川芎嗪组:川芎嗪注射液80mg加人50g/L葡萄糖注射液或生理盐水500mL,静脉滴注,1次/d;l4d后改为川芎嗪片100mg,口服,3次/d;银杏叶提取物组:银杏叶提取物注射液70mg加人50g/L葡萄糖注射液或生理盐水500mL,静脉滴注,1次/d;14d后改为银杏叶片80mg,口服,3次/d。治疗前后运用简易精神状态量表评估其认知障碍。判断根据不同文化程度分为文盲≤17分,小学≤20分,初中<21分,高中<22分,大学≤23分。并应用P300潜伏期对其认知功能定量化评估。测定血浆、脑脊液中精氨酸加压素含量评估治疗效果应用放射免疫分析法。结果:参加实验人数及进入结果分析人数均为100例,中途无脱落。①药物干预治疗前后两组患者血浆、脑脊液中精氨酸加压素含量变化:与治疗前相比,治疗后银杏叶提取物组、川芎嗪组血浆中精氨酸加压素含量差异不显著犤(4.25±0.62),(4.28±0.38)ng/L;(4.31±0.43),(4.12±0.85)ng/L,P>0.05犦,脑脊液中精氨酸加压素含量明显增高犤(2.72±0.53),(1.65±0.73)ng/L;(2.84±0.58),(1.64±0.46)ng/L,P<0.05犦;治疗后川芎嗪组与银杏叶提取物组血浆,脑脊液中精氨酸加压素含量差异不显著(P>0.05)。②药物干预治疗前后两组患者认知功能变化:与治疗前比较,银杏叶提取物组、川芎嗪组治疗后简易精神状态量表评分明显增高(18.63±5.18,16.38±9.25;18.74±6.35,14.69±5.37,P<0.05),P300潜伏期值显著缩短犤(337.74±31.56),(453.42±30.23)ms;(382.15±28.42),(435.68±32.27)ms,P<0.01犦;治疗后川芎嗪组、银杏叶提取物组简易精神状态量表评分、P300潜伏期值差异不显著(P>0.05)。结论:川芎嗪治疗可提高血管性痴呆患者脑脊液中精氨酸加压素含量,对血管性痴呆患者的认知功能有一定的改善作用,其效应与银杏叶提取物相似。
AIM： The levels of arginine vasopressin in plasma and cerebrospinal fluid are associated with the transmission of neurotransmitter and the activities of learning and memory function in patients with vascular dementia. The aim of the paper is to investigate the association between cognitive function and the level of arginine vasopressin in patients with vascular dementia after treatment of tetramethylpyrazine, and take ginkgo leaf extract as the standard control. METHODS： Totally 100 patients with vascular dementia in the Department of Neurology, Zhuanghe Central Hospital between January 2000 and December 2003 were divided into telramethylpyrazine group and ginkgo leaf extract group.In the tetramethylpyrazine group： Tetramethylpyrazine parenteral solution （80 rag） was added into 500 mg glucose parenteral solution or saline （50 g/L）, and then dripped via vein, once a day; after 14 days, tetramethylpyrazine tablet （100 mg） was taken orally, 3 times a day. In the ginkgo leaf extract group： Ginkgo leaf extract parenteral solution （70 mg） was added into 500 mg glucose parenteral solution or saline （50 g/L）, and then dripped via vein, once a day; after 14 days, ginkgo leaf extract tablet （80 mg） was taken orally, 3 times a day. Their cognitive disorders were assessed with mini-mental state examination before and after treatment. According to the educational background, the patients were divided into illiterate ≤ 17 points, elementary school ≤ 20 points, junior middle school 〈 21 points, senior middle school 〈 22 points, university 〈 23 points. Their cognitive function was evaluated quantitatively with the P300 latencies. The contents of arginine vasopressin in plasma and cerebrospinal fluid were detected to assess the therapeutic efficacy by means of radioimmunoassay. RESULTS： All the 100 cases were involved in the analysis of results, no one missed midway. ①The changes of content of arginine vasopressin in plasma and cerebrospinal fluid before and after drug intervention in both groups： As compared with before treatment, the contents of arginine vasopressin in plasma after treatment were insignificantly changed in the ginkgo leaf extract group and tetramethylpyrazine group [（4.25 ±0.62）, （4.28±.38） ng/L; （4.31±.43）, （4.12±0.85） ng/L, P 〉 0.05]; those in cerebrospinal fluid were obviously increased [（2.72±0.53）, （1.65±0.73） ng/L; （2,84±0.58）, （1.64±0.46） ng/L, P 〈 0.05]. After treatment, the contents of arginine vasopressin in plasma and cerebrospinal fluid were insignificantly different between the ginkgo leaf extract group and tetramethylpyrazine group （P 〉 0.05）. ② The changes of content of cognitive function before and after drug intervention in both groups： As compared with before treatment, the scores of mini-mental slate examination after treatment in the ginkgo leaf extract group and tetramethylpyrazine group were obviously increased （18.63±5.18, 16.38±9.25; 18.74±6.35, 14.69±5.37, P〈0.05）, the P300 lateneies were significantly shortened [（337.74±31.56）, （453.42±30.23） ms; （382.15±28.42）, （435.68±32.27） ms, P 〈 0.01]. After treatment, the more of mini-mental state examination and P300 latency were insignificantly different between the tetramethylpyrazine group and ginkgo leaf extract group （P 〉 0.05）. CONCLUSION： content of arginine Treatment of tetramethylpyrazine can improve the vasopressin in cerebrospinal fluid of patients withvascular dementia, and plays a certain role in ameliorating the cognitive function of patients with vascular dementia, its effect is similar to that of ginkgo leaf extract.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期194-196,共3页
Chinese Journal of Clinical Rehabilitation
