氯沙坦联合叶酸对老年H型高血压急性脑梗死患者认知功能障碍的改善作用及PI3K/AKT参与机制  

Study on the PI3K/AKT participation mechanism of cognitive dysfunction in elderly patients with type H hypertensive acute cerebral infarction and improving effect of losartan combined with folic acid

作　　者：杨明 王春娟 刘世昱 YANG Ming;WANG Chunjuan;LIU Shiyu(Department of Geriatrics,Inner Mongolia Forestry General Hospital, Inner Mongolia, Yakeshi 022150,China)

机构地区：[1]内蒙古林业总医院老年病科,内蒙古自治区牙克石市022150

出　　处：《河北医药》2020年第12期1797-1800,共4页Hebei Medical Journal

摘　　要：目的分析老年H型高血压急性脑梗死患者认知功能障碍的PI3K/AKT参与机制及氯沙坦联合叶酸的改善作用。方法选择2015年1月至2018年8月诊治的老年H型高血压急性脑梗死患者140例,患者按治疗方法分为对照组和观察组,每组70例。对照组采用氯沙坦治疗,观察组采用氯沙坦联合叶酸治疗。分析2组患者经治疗后认知功能评分的改善作用,酶联免疫吸附测定法治疗前后NSE、S100β和Aβ水平的变化,Western Blotting法分析治疗前后PI3K/AKT信号通路蛋白表达的变化。结果2组患者治疗后脑血流动力学参数Qmean、Vmean、Vmax及Vmin均明显升高(P<0.05),而收缩压、Hcy、Wv和Rv水平均明显降低(P<0.05),MoCA量表评分及MMSE量表评分均明显升高(P<0.05)而SDS评分均明显降低(P<0.05);治疗后NSE、S100β和Aβ、PI3K、AKT及mTOR蛋白水平均明显降低(P<0.05)。观察组患者的上述指标变化较对照组更显著(P<0.05)。结论氯沙坦联合叶酸能有效改善老年H型高血压急性脑梗死患者认知功能障碍及脑血流动力学参数异常,且明显抑制PI3K/AKT信号通路蛋白水平。Objective To investigate the PI3K/AKT participation mechanism of cognitive dysfunction in elderly patients with type H hypertensive acute cerebral infarction and improving effect of losartan combined with folic acid.Methods A total of 140 elderly patients with type H hypertensive acute cerebral infarction,who were treated in our hospital from January 2015 to August 2018,were divided into control group(n=70)and observation group(n=70)according to different treatment methods.The patients in control group were treated by losartan,while those in observation group were treated by losartan combined with folic acid.After treatment the improvement effects of cognitive function score were observed and compared between the two groups.Moreover,ELISA was used to determine the changes of the levels of NSE,S100βand Aβbefore and after treatment.Western Blotting method was used to analyze the changes of the expression of PI3K/AKT signaling pathway protein before and after treatment.Results After treatment,the cerebral hemodynamic parameters including Qmean,Vmean,Vmax and Vmin were significantly increased in both groups(P<0.05),while the levels of SBP,Hcy,Wv and Rv were significantly decreased in both groups(P<0.05).Moreover,the scores of MoCA scale and MMSE scale scores were increased significantly in both groups(P<0.05),but the scores of SDS were decreased significantly(P<0.05).Furthermore,the levels of NSE,S100beta,Aβ,PI3K and mTOR protein were significantly decreased in both groups(P<0.05).In addition,the changes of the indexes mentioned above in observation group were more significant than those in control group(P<0.05).Conclusion The losartan combined with folic acid can effectively improve the cognitive impairment and abnormal cerebral hemodynamic parameters in elderly patients with type H hypertensive acute cerebral infarction,which can significantly inhibit PI3K/AKT signaling pathway protein levels.

关 键 词：H型高血压 脑梗死急性 认知功能障碍 PI3K/AKT信号转导通路 氯沙坦 叶酸 

分 类 号：R743.33[医药卫生—神经病学与精神病学]