双嘧达莫联合奥拉西坦对皮质下缺血性血管性痴呆患者血管内皮生长因子、血红素氧化酶-1、低氧诱导因子-1α水平的影响  

Effect of dipyridamole combined with oxiracetam on serum levels of vascular endothelial growth factor,heme oxygenase-1,hypoxia-inducible factor-1αin patients with subcortical ischemic vascular dementia

作　　者：李婷婷 赵俊杰 吴钦娟 亓勤德 LI Ting-ting;ZHAO Jun-jie;WU Qin-juan(Department of Neurology,Jinan City People's Hospital,Jinan 271100,China)

机构地区：[1]济南市人民医院神经内科,271100

出　　处：《临床神经病学杂志》2021年第6期431-435,共5页Journal of Clinical Neurology

摘　　要：目的探讨双嘧达莫联合奥拉西坦治疗皮质下缺血性血管性痴呆(SIVD)的疗效及对患者血清血管内皮生长因子(VEGF)、血红素氧化酶-1(HO-1)、低氧诱导因子-1α(HIF-1α)水平的影响。方法将96例SIVD患者随机分为观察组与对照组,每组48例。两组均应用常规治疗,对照组应用奥拉西坦,观察组应用双嘧达莫联合奥拉西坦。对比两组治疗前后的MMSE评分、蒙特利尔认知评估量表(MoCA)、NIHSS评分及Barthel指数(BI),对比两组治疗前后血清VEGF、HO-1、HIF-1α、可溶性Fas(sFas)、sFas抗体(sFasL)及IL-18水平的差值。结果治疗后,观察组MMSE、MoCA、NIHSS、BI等各项评分差值均显著高于对照组(均P<0.05);观察组血清VEGF、HO-1、HIF-1α水平差值均显著高于对照组(均P<0.05),sFas、sFasL及IL-18水平差值均显著高于对照组(均P<0.05)。结论双嘧达莫联合奥拉西坦治疗SIVD能够更好地促进认知功能及神经功能的恢复,改善日常生活活动能力,其机制可能与更好地促进VEGF、HO-1、HIF-1α表达上调而促进血管修复并抑制细胞凋亡、缺氧及炎症损伤有关。Objective To investigate the efficacy of dipyridamole combined with oxiracetam in the treatment of patients with subcortical ischemic vascular dementia(SIVD)and influence on serum levels of vascular endothelial growth factor(VEGF),heme oxygenase-1(HO-1),hypoxia-inducible factor-1α(HIF-1α).Methods Ninety-six patients with SIVD were randomly divided into observation group and control group,with 48 cases in each group.Both groups received routine treatment,the control group received oxiracetam treatment,the observation group received dipyridamole combined with oxiracetam treatment.The MMSE,Montreal Cognitive Assessment(MoCA),NIHSS and the Barthel Index(BI)were compared between the two groups before and after treatment.Differences of serum levels of VEGF,HO-1,HIF-1α,soluble Fas(sFas),sFas antibody(sFasL)and IL-18 were compared between the two groups before and after treatment.Results After treatment,the differences of MMSE,MoCA,NIHSS and BI score of the observation group were significantly higher than those of the control group(all P<0.05).The serum level differences of VEGF,HO-1,HIF-1αin the observation group were significantly higher than those in the control group(all P<0.05),and the level differences of sFas,sFasL and IL-18 were also significantly higher than those in the control group(all P<0.05).Conclusion Dipyridamole combined with oxiracetam in the treatment of SIVD can further promote the recovery of cognitive function and neurological function,improve the ability of daily living,its mechanism may be related to the better up-regulation of VEGF,HO-1,HIF-1αlevels to promote vascular repair and inhibit apoptosis,hypoxia and inflammatory damage.

关 键 词：皮质下缺血性血管性痴呆 双嘧达莫 奥拉西坦 血管内皮生长因子 血红素氧化酶-1 低氧诱导因子-1Α 

分 类 号：R749.13[医药卫生—神经病学与精神病学]