石杉碱甲对阿尔茨海默病患者血小板膜Fas及Apo2.7和Bcl-2水平与认知功能的影响(英文)  

Impacts of huperzine A on the level of Fas,Apo2.7 and Bcl-2 on the platelet membrane and the cognitive function in patients with Alzheimer disease

作　　者：薛慎伍[1] 丁建民[1] 钟萍[1] 梁堃[1] 安洪英[1] 薄云[1] 

机构地区：[1]解放军济南军区总医院神经内二科,山东省济南市250031

出　　处：《中国临床康复》2005年第9期188-189,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:石杉碱甲是中国首创的一种从中国中草药蛇足石杉中提取的一种可逆性胆碱酯酶抑制剂,其机制是通过阻止乙酰胆碱酯酶的水解而增加神经突触中的乙酰胆碱浓度,提高痴呆患者胆碱功能,改善认知状态。目的:研究石杉碱甲对阿尔茨海默病患者认知功能改善的作用。设计:以患者为研究对象,随机化同期对照研究。单位:一所军区总医院神经内二科。对象:2000-03/2003-12解放军济南军区总医院神经内二科住院的阿尔茨海默病(AD)患者69例,按患者意愿分为石杉碱甲组38例,均为男性,年龄68～84岁,平均76岁。对照组31例,男性,年龄68～80岁,平均74岁。主要观察指标:两组治疗后血小板膜Fas,Apo2.7,Bcl-2阳性表达的百分率和简易精神状态量表(MMSE),长谷川痴呆量表(HDS),日常生活活动能力(ADL)积分。结果:石杉碱甲治疗组治疗后外周血血小板膜Fas,Apo2.7,bcl-2阳性表达率分别为(2.23±0.49)%,(2.37±0.36)%,(2.01±0.32)%,均低于对照组(3.12±0.74)%,(2.83±0.67)%,(2.59±0.54)%,经统计学处理,差异有显著性意义(P<0.01)。石杉碱甲组预后MMSE,HDS和ADL积分为20.45±4.14,21.39±4.89,36.15±5.11显著高于或低于对照组15.76±3.23,17.32±2.09,44.26±7.21,差异有显著性意义(P<0.05)。BACKGROUND:Huperzine A is a reversible cholinesterase inhibitor extracted initially by China from huperzia serrata,a Chinese herb. Its mechanism in improving choline function and ameliorating cognitive state of patients with dementia is to increase acetylcholine (Ach) concentration in neural synapse through impeding the hydrolysis of acetylcholinesterase.OBJECTIVE:To investigate the effects of huperzine A on the improvement of cognitive function of patients with Alzheimer disease (AD).DESIGN:A randomized controlled study based on patients.SETTING:Second internal department of neurology in a general hospital of military area command of Chinese PLA.PARTICIPANTS:Totally 69 AD patients hospitalized in the Second Department of Neurology,General Hospital of Jinan Military Area Command of Chinese PLA between March 2000 and December 2003 were allocated into huperzine A group(n=38,male,aged between 68 and 84 years old,average age of 76 years old) and control group(n=31,male,aged between 68 and 80 years old,average age of 74 years old) according to the wills of the patients.MAIN OUTCOME MEASURES:Positive expression percentage of Fas,Apo2.7 and Bcl- 2 on platelet membrane and the integral of mini- mental state examination(MMSE),Hasegawa's dementia scale(HDS) and activities of daily living(ADL) of two groups after therapy.RESULTS:The positive expression of Fas,Apo2.7 or Bcl- 2 on peripheral platelet membrane after therapy in huperzine A group were (2.23± 0.49)% ,(2.37± 0.36)% ,or(2.01± 0.32)% respectively,which was significantly lower than(3.12± 0.74)% , (2.83± 0.67)% or (2.59± 0.54)% of control group(P< 0.01).The prognostic integral of MMSE,HDS or ADL of huperzine A group was 20.45± 4.14,21.39± 4.89,or 36.15± 5.11, which was significantly higher or lower than that of the control group(15.76± 3.23,17.32± 2.09,44.26± 7.21)(P< 0.05).CONCLUSION:Huperzine A actually can effectively improve the memory and cognitive function of AD,and effectively improve ADL as well.

关 键 词：阿尔茨海默病 认知 细胞凋亡 

分 类 号：R749.1[医药卫生—神经病学与精神病学]