重复经颅磁刺激对非痴呆型血管性认知功能障碍患者血清瘦素水平的影响  

Effects of repetitive transcranial magnetic stimulation on serum leptin level in patients with non- dementia vascular cognitive dysfunction

作　　者：王莉[1] 张燕[1] 余巨明[1] 

机构地区：[1]川北医学院附属医院神经内科,四川南充637000

出　　处：《徐州医学院学报》2016年第2期119-122,共4页Acta Academiae Medicinae Xuzhou

基　　金：四川省卫生厅科学研究项目（120446）

摘　　要：目的研究重复经颅磁刺激对非痴呆型血管性认知功能障碍患者血清瘦素水平的影响。方法选择2012年6月至2015年6月在川北医学院附属医院就诊的非痴呆型血管性认知功能障碍患者80例，按照随机数字表法将所有患者分为4组，每组20例，其中1组为对照组，剩余3组为实验组，实验组又分为高频组、中频组、低频组。对照组患者采用常规治疗方法，实验组患者在对照组的基础上采用重复经颅磁刺激治疗，低频组、中频组、高频组刺激频率分别为0．5、3、5Hz。治疗前后，对患者进行氢质子磁共振波谱分析、事件诱发电位P300检测，并检测血清瘦素、血浆内皮素-1（ET-1）、血管内皮生长因子（VEGF）、血清神经生长因子（NGT），用简易智能精神状态检查量表（MMSE）、认知功能损害量表（MoCA）评定患者的认知功能，记录患者的不良反应。结果实验组较对照组P300潜伏期明显缩短，磁共振波谱明显增高，高频组和中频组较低频组P300潜伏期明显缩短，磁共振波谱明显增高（P〈0．05）；高频组和中频组患者P300潜伏期和磁共振波谱比较差异无统计学意义（P〉0．05）。实验组3组血清瘦素、VEGF、NGT水平及MMSE、MoCA评分均明显高于对照组，ET-1低于对照组，差异有统计学意义（〈0．05）；高频组、中频组患者血清瘦素、VEGF、NGT水平及MMSE、MoCA评分的差异无统计学意义（P〉0．05），但明显高于对照组和低频组，ET-1低于对照组和低频组，差异有统计学意义（P〈0．05）。高频组不良反应发生率明显高于其他组，差异有统计学意义（P〈0．05）；中频组、低频组和对照组不良反应发生率的差异无统计学意义（P〉0．05）。结论重复经颅磁刺激能够明显增加非痴呆型血管性认知功能障碍患者的血清瘦素水平，提高患者的认知功能，且最佳磁刺激频率为3Hz。Objective To investigate the effects of repetitive transcranial magnetic stimulation on the level of serum leptin in patients with non - dementia vascular cognitive dysfunction. Methods A total of 80 patients who were diag- nosed with non - dementia vascular cognitive dysfunction in our hospital from June 2012 to June 2015 were enrolled in the current study. These patients were randomly divided into four groups （ n = 20） ： a control group, a high frequency group, a medium frequency group, and a low frequency group. The control group was given routine therapy, while patients in the other groups underwent repetitive transcranial magnetic stimulation in addition to routine therapy. The stimulation, fre- quency was 0. 5 Hz for the low frequency group, 3 Hz for the medium frequency group, and 5 Hz for the high frequency group. Before and after treatment, all patients underwent proton magnetic resonance spectroscopy and P300 event evoked potential detection. Meanwhile, the levels of serum leptin, endothelin - 1 （ ET - 1 ）, vascular endothelial growth factor （ VEGF）, and nerve growth factor （NGF） were detected. These patients were scored according to mini - mental state ex- amination （MMSE） scale, and cognitive function impairment scale. Adverse reactions were recorded. Results Com- pared with the control, the other three groups presented obviously shorter P300 latency but markedly enhanced MRS spec- trum （P 〈 0.05）. The high and medium frequency groups showed obviously shorter P300 latency but markedly enhancedMRS spectrum than the low frequency group （ P 〈 0.05 ）. Compared with the control, the other three groups produced ob- viously increased levels of serum leptin, VEGF and NGT, higher MMSE and MoCA scale scores, but lower ET - 1 level （P 〈 0.05）. The high and medium frequency groups produced obviously increased levels of serum leptin, VEGF and NGT, higher MMSE and MoCA scale scores, but lower ET - 1 level than the low frequency group （ P 〈 0.05 ）. No signif- icant diffe

关 键 词：重复经颅磁刺激 非痴呆型 血管认知功能障碍 血清瘦素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]