摘要
目的:探索多奈哌齐联合尼莫地平在血管性痴呆患者中的应用。方法:选取开封市中医院2020年6月至2023年7月收治的102例血管性痴呆患者为研究对象,按照随机数字表法分为钙拮抗剂组和抗胆碱能组,各51例。钙拮抗剂组患者接受尼莫地平治疗,抗胆碱能组患者在钙拮抗剂组的基础上增加多奈哌齐治疗。比较两组患者脑灌注参数[平均通过时间(MTT)、脑血容量(CBV)及脑血流量(CBF)]水平,认知水平[长谷川痴呆量表(HDS)、蒙特利尔认知评估量表(MoCA)评分],血清相关因子[脂蛋白相关磷脂酶A2(Lp-PLA2)、脑源性神经营养因子(BDNF)及血管紧张素1-7(Ang1-7)]水平。结果:治疗后,两组患者MTT较治疗前降低,且抗胆碱能组低于钙拮抗剂组,而两组患者CBV、CBF水平较治疗前均升高,且抗胆碱能组高于钙拮抗剂组,差异均有统计学意义(P<0.05);治疗后,两组患者HDS、MoCA评分较治疗前均升高,且抗胆碱能组高于钙拮抗剂组,差异均有统计学意义(P<0.05);治疗后,两组患者血清Lp-PLA2水平较治疗前降低,且抗胆碱能组低于钙拮抗剂组,两组患者血清BDNF、Ang1-7水平较治疗前升高,且抗胆碱能组高于钙拮抗剂组,差异均有统计学意义(P<0.05)。结论:多奈哌齐联合尼莫地平可改善血管性痴呆患者脑灌注参数及认知水平,并能调节血清相关因子水平。
Objective To explore the application of donepezil combined with nimodipine in patients with vascular dementia.Methods A total of 102 patients with vascular dementia admitted to Kaifeng Hospital of Traditional Chinese Medicine from June 2020 to July 2023 were selected as the research subjects and randomly divided into the calcium antagonist group and the anticholinergic group,with 51 cases in each group.Patients in the calcium antagonist group were treated with nimodipine,while patients in the anticholinergic group were treated with donepezil in addition to nimodipine.The cerebral perfusion parameters[mean transit time(MTT),cerebral blood volume(CBV),and cerebral blood flow(CBF)],cognitive levels[Hasegawa Dementia Scale(HDS)and Montreal Cognitive Assessment(MoCA)scores],and serum-related factor levels[lipoprotein-associated phospholipase A2(Lp-PLA2),brain-derived neurotrophic factor(BDNF),and angiotensin 1-7(Ang1-7)]were compared between the two groups.Results After treatment,the MTT in both groups decreased compared with those before treatment,and the anticholinergic group was lower than the calcium antagonist group.The levels of CBF and CBV in both groups increased compared with those before treatment,and the anticholinergic group was higher than the calcium antagonist group.The differences were statistically significant(P<0.05).After treatment,the HDS and MoCA scores in both groups increased compared with those before treatment,and the anticholinergic group was higher than the calcium antagonist group.The differences were statistically significant(P<0.05).After treatment,the levels of serum Lp-PLA2 in both groups decreased compared with those before treatment,and the anticholinergic group was lower than the calcium antagonist group.The levels of serum BDNF and Ang1-7 levels in both groups increased compared with those before treatment,and the anticholinergic group was higher than the calcium antagonist group.The differences were statistically significant(P<0.05).Conclusion Donepezil combined with nimodipine can improve cerebral perfusion parameters and cognitive levels in patients with vascular dementia and regulate serum-related factor levels.
作者
王振坤
许梁洁
WANG Zhenkun;XU Liangjie(Department of Neurology,Kaifeng Hospital of Traditional Chinese Medicine,Henan Kaifeng 475000)
出处
《深圳中西医结合杂志》
2025年第6期10-13,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
