运动锻炼对早期阿尔茨海默病病人认知功能以及血清神经营养因子的影响  

Effects of exercise on cognitive function and serum levels of neurotropic factor in patients with early stage of Alzheimer’s disease

作　　者：刘忆[1] 张利丽[1] 董靖德[1] LIU Yi;ZHANG Li-li;DONG Jing-de(Department of Geriatrics,Nanjing Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院老年医学科

出　　处：《实用老年医学》2019年第11期1077-1080,共4页Practical Geriatrics

基　　金：江苏省干部保健科研课题(BJ18003)

摘　　要：目的探索运动锻炼对早期阿尔茨海默病(AD)病人认知功能和血清脑源性神经营养因子(BDNF)、胰岛素样生长因子1(IGF-1)水平的影响。方法将早期AD病人随机分为运动干预组和对照组,运动干预组进行每周至少3~4次,每次30 min的慢走,10 min的肢体伸张灵活性训练以及10 min的平衡训练,对照组进行每周至少3~4次,每次5~10 min肢体伸张灵活性训练,为期1年。干预前后,对2组行简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、阿尔茨海默病评定量表-认知分量表(ADAS-cog)、临床痴呆评定量表(CDR)、日常生活活动能力量表(ADL)检查评估认知功能及日常生活能力并行比较分析;用ELISA法检测2组病人干预前后血清BDNF和IGF-1水平的变化。结果运动锻炼干预1年后,运动干预组MMSE、MoCA评分高于对照组,ADAS-cog低于对照组,差异有统计学意义(P<0.05);运动干预组的血清BDNF水平明显高于对照组,差异有统计学意义(P<0.05);2组间血清IGF-1水平差异无统计学意义。结论运动锻炼可以延缓早期AD病人认知功能的下降,提高血清中BDNF的含量,但对于改善早期AD病人的日常生活能力有限。Objective To explore the effects of exercise on cognitive function,and the levels of serum brain-derived neurotrophic factor(BDNF)and insulin-like growth factor 1(IGF-1)in the patients with early stage of Alzheimer's disease(AD).Methods The AD patients were divided into the exercise intervention group and the control group.The exercise intervention group performed 30 minutes of slow walking,10 minutes of physical extension exercise and 10 minutes of balance training exercise intervention,at least 3-4 times a week for 1 year.The control group performed 5-10 minutes of limb extension flexibility training exercise intervention at least 3-4 times a week for 1 year.The neuropsychology scales such as mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),Alzheimer's disease assessment scale(ADAS-cog),clinical dementia rating(CDR),activity of ability of daily living(ADL)were examined to evaluate the cognitive function and ADL of the two groups;Serum levels of BDNF and IGF-1 in the two groups were detected by ELISA.Results After one-year exercise intervention,comparing to the control group,the scores of MMSE,MoCA were higher,while the score of ADAS-cog was lower in the exercise intervention group(P<0.05).But there was no significant difference in ADL between the two groups.The serum level of BDNF in the exercise intervention group was significantly higher than that of the control group.Serum level of IGF-1 was not significantly different between the two groups.Conclusions Exercise can delay the decline of cognitive function in AD patients at early stage and increase the concentration of BDNF in serum.But it does not help to improve the ADL of AD patients with early stage.

关 键 词：运动锻炼 阿尔茨海默病 认知功能 脑源性神经营养因子 胰岛素样生长因子 

分 类 号：R749.1[医药卫生—神经病学与精神病学]