丁苯酞对帕金森病认知障碍患者血清同型半胱氨酸的影响  

Effect of Butylphthalide on Serum Homocysteine in Patients with Cognitive Impairment of Parkinson's Disease

作　　者：宋丽倩[1] 林杰[1] 武一平[1] 智孔亮[1] 李晓利[1] 王晓静 Song Liqian;Lin Jie;Wu Yiping;Zhi Kongliang;Li Xiaoli;Wang Xiaojing(Department of Neurology,Handan First People's Hospital,Handan,Hebei,China 056000)

机构地区：[1]河北省邯郸市第一医院神经内科,河北邯郸056000

出　　处：《中国药业》2018年第24期64-67,共4页China Pharmaceuticals

基　　金：河北省医学科学研究重点课题资助项目[20171089]

摘　　要：目的探讨丁苯酞对帕金森病认知障碍患者血清同型半胱氨酸的影响。方法选取医院2012年8月至2016年8月收治的帕金森病患者288例,依据蒙特利尔认知评估量表(MoCA)评分将患者分为A组(认知障碍组,MoCA评分<26分,132例)和B组(无认知障碍组,MoCA评分≥26分,156例),再分别均分为A_1组、A_2组及B_1组、B_2组。4组患者均给予左旋多巴片治疗,在此基础上,A_2组和B_2组患者加服丁苯酞软胶囊。结果治疗第4,12,24周时,4组患者MoCA评分、简易智能状态检查量表(MMSE)评分、简明健康状况调查量表(SF-36)评分、健康相关生活质量(HRQoL)评分均逐渐升高,A_2组和B_2组评分升高幅度较大,且评分分别高于A_1组和B_1组(P <0. 05); 4组患者统一帕金森病评定量表(UPDRS)评分、39项帕金森病调查表(PDQ-39)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分均逐渐降低,A_2组和B_2组评分降低幅度较大,且评分分别低于A_1组和B_1组(P <0. 05);治疗后,4组患者血清同型半胱氨酸(HCY)水平较治疗前均降低,且A_2组和B_2组分别低于A_1组和B_1组(P <0. 05); 4组不良反应发生率均较低且相当,均未出现严重不良反应,并自行康复。结论帕金森病认知障碍患者HCY水平显著高于无认知障碍患者,丁苯酞可显著改善患者不良情绪,且可改善认知障碍和帕金森病,提高生活质量。Objective To investigate the effect of butylphthalide on serum homocysteine( HCY) in patients with cognitive impairment of Parkinson’s disease. Methods Totally 288 patients with Parkinson’s disease admitted to our hospital from August 2012 to August 2016 were selected,according to the Montreal cognitive assessment scale( MoCA),the patients were divided into group A( cognitive impairment group,MoCA < 26 points,n = 132) and group B( non-cognitive impairment group,MoCA ≥ 26 points,n = 156). According to a ratio of1 ∶ 1,the patients in group A and group B were divided into group A1 and group A2,group B1 and groups B2. All the four groups were treated with Levodopa Tablets,on this basis,group A2 and group B2 were treated with Butylphthalide Soft Capsules. Results In the 4 th,12 th and 24 th week of treatment,the MoCA score,MMSE score,SF-36 score and HRQoL score of the four groups were gradually increased,the scores of group A2 and group B2 were significantly increased,which were significantly higher than those of group A1 and group B1,respectively( P < 0. 05). The UPDRS score,PDQ-39 score,HAMA score and HAMD score of the four groups were gradually decreased,the scores of group A2 and group B2 were significantly decreased,which were significantly lower than those of group A1 and group B1,respectively( P < 0. 05). After treatment,the levels of HCY in the four groups were lower than those before treatment,and those in group A2 and group B2 were lower than those in group A1 and group B1,respectively( P < 0. 05). The incidence rates of adverse reactions in the four groups were lower and comparable,no serious adverse reactions occurred,and the patients recovered spontaneously. Conclusion The levels of HCY in patients with cognitive impairment of Parkinson’s disease are significantly higher than those in patients without cognitive impairment. Butylphthalide can significantly improve patients’ bad mood,cognitive impairment and Parkinson’s disease,it also can improve the quality of life of patients.

关 键 词：丁苯酞 帕金森病 认知障碍 同型半胱氨酸 生活质量 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R971.5[医药卫生—药学]