多奈哌齐联合丁苯酞对多发性脑梗死性痴呆的预后及血清中血管内皮生长因子、血管内皮生长因子受体水平的影响  

Effect of donepezil combined with butylphthalide on prognosis and serum levels of VEGF and VEGFR in patients with multi infarction dementia

作　　者：陈冬 CHEN Dong(Department of Neurology,Wuhan Sixth Hospital Affiliated to Jianghan University,Wuhan,Hubei 430015,China)

机构地区：[1]江汉大学附属医院武汉市第六医院神经内科,湖北武汉430015

出　　处：《安徽医药》2020年第5期1007-1010,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究多奈哌齐联合丁苯酞对多发性脑梗死性痴呆的预后及血清中血管内皮生长因子(VEGF)、血管内皮生长因子受体(VEGFR)水平的影响。方法选取2018年1月至2019年3月于江汉大学附属武汉市第六医院接受治疗的多发性脑梗死性痴呆病人102例,采用随机数字表法分为观察组与对照组,每组51例,两组病人均参照脑血管病二级预防接受常规治疗,观察组在常规治疗的基础上采用多奈哌齐联合丁苯酞治疗,对照组在常规治疗基础上采用丁苯酞治疗,比较两组治疗前后的精神状态(MMSE)评分、临床痴呆程度(CDR)评分、血清VEGF、VEGFR水平、Fugl Meyer评分的上肢、下肢得分、日常生活能力(ADL)评分变化及不良反应发生情况。结果与治疗前相比,治疗后对照组与观察组MMSE评分[(9.83±2.44)比(14.72±2.31)分,(10.06±2.47)比(18.87±2.22)分]、血清VEGF[(438.36±41.85)比(473.49±43.63)分,(443.17±43.53)比(537.35±41.78)分]、VEGFR[(403.14±40.63)比(476.68±39.62)分,(406.37±41.25)比(503.32±37.43)分]、Fugl Meyer评分的上肢、下肢得分均升高,CDR评分[(2.01±0.77)比(1.34±0.61)分,(1.98±0.76)比(1.09±0.53)分]、ADL评分[(43.67±6.45)比(41.11±6.03)分,(44.03±6.37)比(38.03±6.01)分]均降低,差异有统计学意义(P<0.05);与对照组相比,治疗后观察组病人的MMSE评分、血清VEGF、VEGFR、Fugl Meyer评分的上肢、下肢得分升高,CDR评分、ADL评分降低(P<0.05);观察组不良反应发生率为7.84%(4/51),对照组为5.88%(3/51),两组病人不良反应发生率比较差异无统计学意义(P>0.05)。结论采用多奈哌齐联合丁苯酞治疗多发性脑梗死性痴呆,可升高病人血清中VEGF、VEGFR水平,改善病人预后,提高病人生活质量。Objective To explore the effect of donepezil combined with butylphthalide on the prognosis of multi infarction demen tia and the levels of vascular endothelial growth factor(VEGF)and vascular endothelial growth factor receptor(VEGFR)in serum.Methods 102 patients with multi infarction dementia treated in Wuhan Sixth Hospital affiliated to Jianghan University from Janu ary 2018 to March 2019 were randomly divided into the observation group and the experimental group,51 cases in each group.Both groups received routine treatment according to secondary prevention of cerebrovascular disease.The observation group was treated with donepezil combined with butylphthalide on the basis of routine treatment,while the control group was treated with bu tylphthalide on the basis of routine treatment.The changes of mental state(MMSE)score,clinical dementia rating(CDR)score,levels of serum VEGF,VEGFR,upper limb and lower limb scores of Fugl Meyer score,and activities of daily living(ADL)score,and the adverse reactions were compared between the two groups before and after treatment.Results Compared with before treat ment,MMSE score[(9.83±2.44)vs.(14.72±2.31),(10.06±2.47)vs.(18.87±2.22)],levels of serum VEGF[(438.36±41.85)vs.(473.49±43.63),(443.17±43.53)vs.(537.35±41.78)]and VEGFR[(403.14±40.63)vs.(476.68±39.62),(406.37±41.25)vs.(503.32±37.43)],upper limb and lower limb scores of Fugl Meyer score increased,CDR score[(2.01±0.77)vs.(1.34±0.61),(1.98±0.76)vs.(1.09±0.53)]and ADL score[(43.67±6.45)vs.(41.11±6.03),(44.03±6.37)vs.(38.03±6.01)]decreased in both groups after treatment,with statistical significances(P<0.05).Compared with the control group,the MMSE score,levels of se rum VEGF and VEGFR,upper limb and lower limb scores of Fugl Meyer score increased,while CDR score and ADL score de creased in the observation group after treatment,and the differences were significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(7.84%vs.5.88%,P>0.05).Conclusion Donepez

关 键 词：痴呆 多发性梗死性 多奈哌齐 丁苯酞 血管内皮生长因子类 受体 血管内皮生长因子 预后 

分 类 号：R749.13[医药卫生—神经病学与精神病学]