摘要
目的观察艾地苯醌联合多奈哌齐治疗高龄轻中度血管性痴呆(VD)的疗效及其机制。方法选取无锡市人民医院老年医学科2014年1月~2017年12月门诊及病房的轻中度VD老年患者90例,按照随机数字表法分为艾地苯醌组、多奈哌齐及联合组。艾地苯醌组给予艾地苯醌(30 mg/次,3次/d)口服;多奈哌齐组给予多奈哌齐(5 mg/次,1次/d)口服;联合组予艾地苯醌联合多奈哌齐口服,剂量同上。疗程均为24周。比较治疗前、治疗后简易精神状态检查(MMSE)、阿尔茨海默病评估量表认知部分(ADAS-cog)、阿尔茨海默病协作研究日常能力量表(ADCS-ADL)评分及超氧化物歧化酶(SOD)、一氧化氮(NO)、丙二醛(MDA)水平。结果治疗24周,多奈哌齐及联合组的MMSE评分较治疗前均明显升高,多奈哌齐组及联合组较艾地苯醌组MMSE评分明显升高(P<0.05)。治疗24周,3组ADAS-cog、ADCS-ADL均明显优于治疗前,联合组ADAS-cog、ADCS-ADL均明显优于多奈哌齐组及艾地苯醌组(P<0.05)。治疗24周,与治疗前相比,3组NO、MDA水平均显著降低、SOD水平显著升高(P<0.05);与多奈哌齐组及艾地苯醌组相比,联合组的NO及MDA水平均显著降低,SOD水平显著升高(P<0.05)。结论艾地苯醌、多奈哌齐均能改善VD认知功能,二者联合效果更佳,可能与协同降低了氧化应激水平有关。
Objective To explore the effect and mechanism of idebenone combined with donepezil in the treatment of mild to moderate vascular dementia in older patients.Methods 90 older patients with mild and moderate vascular dementia were enrolled in Wuxi people's Hospital Affiliated to Nanjing Medical University from January 2014 to December 2017.The patients were divided into idebenone group,donepezil group and combination group according to random number table.Idebenone group received idebenone 30 mg,three times a day.Donepezil group received donepezil 5 mg,once a day.The combination group received idebenone(30 mg,three times a day)plus donepezil(5 mg,once a day).The patients were treated for 24 weeks.The mini-mental state examination(MMSE),Alzheimer disease assessment scale-cog(ADAS-cog),and Alzheimer disease cooperative study-activities of daily living(ADCS-ADL)were evaluated.The levels of superoxide dismutase(SOD),nitrogen oxide(NO)and malonaldehyde(MDA)were measured.Results after 24 weeks treatment,MMSE scores in donepezil group and combination group were increased,and were higher than that in idebenone group(P<0.05).The scores of ADAS-cog and ADCS-ADL were improved after treatment for 24weeks in three groups,and were better in combination group than those in donepezil group and idebenone group(P<0.05).The levels of NO and MDA in three groups were decreased,while the level of SOD was increased after 24 weeks of treatment(P<0.05).The levels of NO and MDA in combination group were lower,the level of SOD was higher than those in donepezil group and idebenone group respectively(P<0.05).Conclusion Idebenone and donepezil may improve the cognitive function of patients with vascular dementia.The combination of them demonstrates better effect,which may be associated with the synergistic reduction of the oxidative stress.
作者
张云云
李欣欣
王滨
Zhang Yunyun;Li Xinxin;Wang Bin(Department of General Practice,Wuxi people's Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Neruology,Jiangbei People's Hospital Affiliated to Nantong University,Nanjing 210000,China;Department of Geriatrics,Wuxi people's Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)
出处
《国际老年医学杂志》
2020年第4期205-208,共4页
International Journal of Geriatrics
基金
南京医科大学重点项目(NJMUZD059)。
