摘要
目的探讨帕金森病患者应用吡贝地尔缓释片联合艾地苯醌治疗的临床效果。方法前瞻性选取2021年5月至2023年5月陕西省核工业二一五医院接诊的180例帕金森病患者,按照随机数字表法根据入院顺序编号分为两组,对照组90例患者采取吡贝地尔缓释片治疗,联合组90例患者则加用艾地苯醌治疗。对比两组患者的氧化应激损伤指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)]、脑部单胺类神经递质指标[5羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)]、运动及非运动症状[统一帕金森病评分量表-Ⅲ(UPDRS-Ⅲ)、简易智力状态检查量表(MMSE)]评分、临床疗效以及不良反应。结果与治疗前比较,两组治疗3个月后SOD、GSH-Px水平均上升,且联合组SOD、GSH-Px水平[分别为(124.34±26.33)kU·L^(-1)、(107.69±15.36)U·μg^(-1)]均高于对照组[分别为(109.34±23.11)kU·L^(-1)、(90.36±14.21)U·μg^(-1)](t=4.061、7.856,均P<0.05);两组治疗3个月后MDA均下降,且联合组MDA[(15.68±3.67)mmol·L^(-1)]低于对照组[(21.39±4.29)mmol·L^(-1)](t=9.595,P<0.05);与治疗前比较,两组治疗3个月后5-HT、DA、NE水平均上升,且联合组5-HT、DA、NE水平[分别为(26.48±3.54)ng·mL^(-1)、(8.06±1.35)ng·mL^(-1)、(15.04±1.57)ng·mL^(-1)]高于对照组[分别为(22.34±4.35)ng·mL^(-1)、(6.64±1.03)ng·mL^(-1)、(13.15±1.28)ng·mL^(-1)](t=7.002、7.933、8.851,均P<0.05);两组治疗3个月后MMSE评分均升高,且联合组MMSE评分[(22.95±3.08)分]高于对照组[(18.99±2.46)分](t=9.530,P<0.05);与治疗前比较,两组治疗3个月后UPDRS-Ⅲ评分均下降,且联合组UPDRS-Ⅲ评分[(20.46±5.34)分]低于对照组[(25.33±6.28)分](t=5.604,P<0.05);与对照组总有效率84.44%(76/90)比较,联合组的总有效率94.44%(85/90)更高(χ^(2)=4.766,P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在吡贝地尔缓释片基础上联合艾地苯醌治疗帕金森病患者有助于改善氧化应激指标、脑部单胺类神经递质指标和运动及非运动症状评分,具有较高的疗效和安全性。
Objective To observe the clinical effect of piribedil sustained-release tablets combined with idebenone on treatment of patients with Parkinson’s disease(PD).Methods A total of 180 patients with PD who were treated in the No.215 Hospital of Shaanxi Nuclear Industry from May 2021 to May 2023 were prospectively recruited as the research subjects and randomly divided into the control group with 90 cases and the combination group with 90 cases according to the order of the admission using a random number table method.The control group was treated with piribedil sustained-release tablets and the combination group was added with idebenone.The oxidative stress injury indicators(superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-Px)),brain monoamine neurotransmitters(5-hydroxytryptamine(5-HT),dopamine(DA),norepinephrine(NE)),motor and non-motor symptoms(Unified Parkinson’s Disease Rating Scale-Ⅲ(UPDRS-Ⅲ),Mini-Mental State Examination(MMSE)),clinical efficacy and adverse reactions were observed and compared between the two groups.Results The SOD and GSH-Px levels of the two groups were higher after the treatment for 3 months than before the treatment;the levels of the above indexes of the combination group were respectively(124.34±26.33)kU·L^(-1) and(107.69±15.36)U·μg^(-1),higher than(109.34±23.11)kU·L^(-1) and(90.36±14.21)U·μg^(-1) of the control group(t=4.061,7.856,both P<0.05);after 3 months of treatment,the MDA level of the two groups was decreased and the MDA level of the combination group was(15.68±3.67)mmol·L^(-1),lower than(21.39±4.29)mmol·L^(-1) of the control group(t=9.595,P<0.05).After 3 months of treatment,the levels of 5-HT,DA and NE of the two groups were increased compared with before treatment;the levels of the above indexes of the combination group were respectively(26.48±3.54)ng·mL^(-1),(8.06±1.35)ng·mL^(-1) and(15.04±1.57)ng·mL^(-1),higher than(22.34±4.35)ng·mL^(-1),(6.64±1.03)ng·mL^(-1) and(13.15±1.28)ng·mL^(-1) of the control group(t=7.002,7.933,8.851,all P<0.05).After 3 months of treatment,MMSE score in the two groups rose and the score of(22.95±3.08)points in the combination group was higher than(18.99±2.46)points in the control group(t=9.530,P<0.05).After 3 months of treatment,the UPDRS-Ⅲscore of the two groups was reduced compared with before treatment,and the UPDRS-Ⅲscore of the combination group was(20.46±5.34)points,lower than(25.33±6.28)points of the control group(t=5.604,P<0.05).The total effective rate was 94.44%(85/90)in the combination group,higher than 84.44%(76/90)in the control group(χ^(2)=4.766,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of idebenone and piribedil sustained-release tablets for PD patients is helpful to improve the oxidative stress indicators,brain monoamine neurotransmitters and motor and non-motor symptoms scores of patients,with efficacy and safety high.
作者
吴可君
王婉
吕日琅
陈华
汪明佳
郝瑛子
安衍茹
郭倩
Wu Kejun;Wang Wan;Lyu Rilang;Chen Hua;Wang Mingjia;Hao Yingzi;An Yanru;Guo Qian(Department of Neurology,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China;Department of Pharmacy,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)
出处
《中国药物应用与监测》
2025年第5期761-764,共4页
Chinese Journal of Drug Application and Monitoring
基金
科技部国家重点研发计划课题(2021YFF0901404)。
关键词
帕金森病
艾地苯醌
吡贝地尔
氧化应激损伤
单胺类神经递质
Parkinson’s disease
Idebenone
Piribedil
Oxidative stress injury
Monoamine neurotransmitters
