增服艾地苯醌对34例帕金森病抑郁患者的疗效观察  

Efficacy of additional idebenone in the treatment of 34 patients with Parkinson′s disease with depression

作　　者：赵海龙 王皓 方雨晴 毛飞 赵张宁[2] 田祥奇 徐新荣 王敏[3] 李秀华[2] ZHAO Hailong;WANG Hao;FANG Yuqing;MAO Fei;ZHAO Zhangning;TIAN Xiangqi;XU Xinrong;WANG Min;LI Xiuhua(Affiliated Hospital of Weifang Medical University,School of Clinical Medicine,Weifang Medical University,Weifang 261000,Shandong,China;Department of Neurology,The First Affiliated Hospital of Shandong Frist Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Institute of Neuroimmunology,Shandong Key Laboratory of Rheumatic Disease and Translational Medicine,Jinan 250014,Shandong,China;Key Laboratory of Animal Resistance Biology of Shandong Province,College of Life Science,Shandong Normal University,Jinan 250014,Shandong,China)

机构地区：[1]潍坊医学院附属医院(临床医学院),潍坊医学院,山东潍坊261000 [2]山东第一医科大学第一附属医院(山东省千佛山医院)神经病学,山东省神经免疫研究所,山东省风湿免疫病转化医学重点实验室,山东济南250014 [3]山东师范大学生命科学学院动物抗性重点实验室,山东济南250014

出　　处：《山东大学学报（医学版）》2022年第4期38-44,共7页Journal of Shandong University:Health Sciences

基　　金：山东省重大科技创新工程项目(2018CXGC1502);济南市临床医学科技创新计划(202019111)

摘　　要：目的观察艾地苯醌联合治疗帕金森病抑郁(PDD)患者的疗效,探讨艾地苯醌对PDD患者的神经保护机制。方法选择PDD患者68例,按随机数字表法分为对照组和观察组,每组34例。对照组接受多巴丝肼片和吡贝地尓缓释片治疗,多巴丝肼片初始剂量为0.125 g/次,3次/d,最高≤0.75 g/d,口服。吡贝地尔缓释片初始剂量50 mg/次,1次/d,最大剂量50 mg/次,3次/d,口服,连续治疗12周。观察组在对照组基础上加用艾地苯醌片,30 mg/次,3次/d,口服,连续治疗12周。监测两组患者汉密尔顿抑郁量表(HAMD)及其因子分、汉密尔顿焦虑量表(HAMA)及其因子分、统一帕金森评分量表-Ⅲ(UPDRS-Ⅲ)、帕金森病睡眠量表(PDSS)、简易精神状态检查量表(MMSE)、帕金森病生活质量问卷(PDQ-39)、外周血超氧化物歧化酶(SOD)变化情况。结果治疗后两组HAMD总分及各项因子均较治疗前降低,除体质量减轻和日夜变化外,观察组HAMD总分及焦虑/躯体化、认知障碍、阻滞、睡眠障碍和绝望感五项因子评分低于对照组(P<0.05);治疗后两组HAMA总分及精神性焦虑和躯体性焦虑两项因子分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗后两组UPDRS-Ⅲ评分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗后两组PDSS评分均较治疗前增高(P<0.05),且观察组高于对照组(P<0.05);治疗后两组MMSE评分均较治疗前增高(P<0.05),且观察组高于对照组(P<0.05);治疗后两组PDQ-39评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗12周后,观察组血SOD水平较治疗前增高,对照组血SOD水平较治疗前降低,两组SOD水平差异有统计学意义(P<0.05)。结论艾地苯醌联合治疗能够明显减轻PDD患者的抑郁症状,改善患者运动症状和部分非运动症状,增加PDD患者外周血SOD水平,提高生活质量。Objective To observe the efficacy of idebenone in the treatment of Parkinson?s disease with depression(PDD),and to explore its neuroprotective mechanism.Methods A total of 68 PDD patients were randomly divided into control group(n=34)and observation group(n=34).The control group received oral Dobasil tablets and Piribedil sustained-release tablets for 12 weeks.The initial dose of Dobasil tablets was 0.125 g/time,3 times a day,and the highest dose was≤0.75 g/d.The initial dose of Piribedil sustained-release tablets was 50 mg/time,once a day,and the maximum dose was 50 mg/time,3 times a day.The observation group received oral idebenone plus the same treatment as the control group for 12 weeks.The dose was 30 mg/time,3 times a day.The changes of Hamilton Depression Scale(HAMD)and its factor scores,Hamilton Anxiety Scale(HAMA)and its factor scores,Unified Parkinson?s Scale-Ⅲ(UPDRS-Ⅲ),Parkinson?s Disease Sleep Scale(PDSS),Mini Mental State Examination Scale(MMSE),39-item Parkinson?s Disease Questionnaire(PDQ-39)and superoxide dismutase(SOD)in the peripheral blood were monitored in the two groups.Results After treatment,the total score of HAMD and all factors in both groups were decreased.Except for weight loss and diurnal changes,the total score of HAMD and the scores of anxiety/somatization,cognitive impairment,block,sleep disorder and despair were significantly lower in the observation group than in the control group(P<0.05).The total score of HAMA and the scores of mental anxiety and somatic anxiety were decreased in both groups(P<0.05),and were significantly lower in the observation group than in the control group(P<0.05).The scores of UPDRS-Ⅲwere decreased in both groups(P<0.05),and were significantly lower in the observation group than in the control group(P<0.05).The PDSS scores were increased in both groups(P<0.05),and were significantly higher in the observation group than in the control group(P<0.05).The MMSE scores were increased in both groups(P<0.05),and were significantly higher in the observatio

关 键 词：帕金森病 抑郁 艾地苯醌 运动症状 非运动症状 

分 类 号：R742.5[医药卫生—神经病学与精神病学]