摘要
目的探讨疏血通联合艾地苯醌对老年血管性痴呆的治疗效果及其对脑血流灌注、神经电生理的影响。方法选取2020年1月至2022年4月于许昌医院诊治老年血管性痴呆患者123例为研究对象,分为对照组61例、观察组62例。对照组给予艾地苯醌治疗,观察组给予疏血通+艾地苯醌治疗。对比分析两组临床疗效。统计对比两组治疗前后脑血流灌注指标[平均通过时间(MTT)、脑血流量(CBV)、血流速度(CBF)],神经电生理[P300潜伏期、P300振幅、(δ+θ)/(α+β)],氧化应激[过氧化脂质(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)],神经功能相关指标[脂蛋白相关磷脂酶A2(Lp-PLA2)、脑源性神经营养因子(BDNF)、血管紧张素1-7(Ang1-7)]。对比两组认知功能[简易精神状态量表(MMSE)评估认知功能],生活能力(Barthel指数评估日常生活自理能力)及安全性。结果观察组总有效率(91.94%)高于对照组(78.69%),P<0.05;治疗后观察组MTT、P300潜伏期、(δ+θ)/(α+β)低于对照组,CBV、CBF、P300振幅高于对照组(P<0.05);治疗后观察组血清LPO、MDA、Lp-PLA2水平低于对照组,SOD、BDNF、Ang1-7水平高于对照组(P<0.05);治疗后观察组MMSE评分、Barthel评分高于对照组(P<0.05)。两组药物不良反应发生率比较差异无统计学意义(P>0.05)。结论疏血通联合艾地苯醌治疗老年血管性痴呆疗效确切,可改善脑血流灌注、神经电生理功能,降低氧化应激水平,并可调节血清Lp-PLA2、BDNF、Ang1-7水平,促进认知功能、生活能力恢复,且具有一定安全性。
Objective To investigate the therapeutic effect of shuxuetong combined with idebenone on elderly vascular dementia and its effects on cerebral blood perfusion and neural electrophysiology.Methods From January 2020 to April 2022,123 elderly vascular dementia patients were treated in Xuchang Hospital as the study subjects,which were divided into 61 cases in the control group and 62 cases in the observation group.The control group was treated with idebenone,and the observation group was treated with shuxuetong+idebenone.The clinical efficacy of the two groups was compared and analyzed.Cerebral blood perfusion indexes[mean transit time(MTT),cerebral blood volume(CBV),cerebral blood flow velocity(CBF)],neural electrophysiology[P300 latency,P300 amplitude,(δ+θ)/(α+β)],oxidative stress[lipid peroxide(LPO),malondialdehyde(MDA),superoxide dismutase(SOD)],neurofunction-related indexes[lipoprotein-associated phospholipase A2(Lp-PLA2),brain-derived neurotrophic factor(BDNF),angiotensin1-7(Ang1-7)].The two groups were compared with cognitive function[Mini-Mental State Scale(MMSE)to assess cognitive function],life ability(barthel index to assess self-care ability in daily living)and safety.Results The total effective rate in the observation group(91.94%)was higher than that of the control group(78.69%),P<0.05;the MTT,P300 latency,(δ+θ)/(α+β)of the observation group after treatment were lower than that of the control group,and the CBV,CBF and P300 amplitude were higher than those of the control group(P<0.05);the serum levels of LPO,MDA and Lp-PLA2 in the observation group after treatment were lower than those in the control group,and the SOD,BDNF,the levels of Ang1-7 were higher than those in the control group(P<0.05),and the MMSE score and Barthel score in the observation group after treatment were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Shuxuetong combined with idebenone has a definite effect in the treatment of elderly vascular dementia,which can improve cerebral blood perfusion,neural electrophysiology function,reduce the level of oxidative stress,and regulate serum Lp-PLA2,BDNF,Ang-17 levels,promote cognitive function and life ability recovery,and have certain safety.
作者
许鹏龙
柴红杰
周永生
XU Penglong;CHAI Hongjie;ZHOU Yongsheng(Xuchang Hospital,Xuchang Henan 461000,China)
出处
《药品评价》
CAS
2023年第3期359-362,共4页
Drug Evaluation
