盐酸多奈哌齐联合综合康复训练对老年痴呆患者认知功能、事件相关电位及血清BDNF、IGF-1的影响  

Effects of Donepezil Hydrochloride Combined with Comprehensive Rehabilitation Training on Cognitive Function, Event-Related Potential and Serum BDNF, IGF-1 in Patients with Senile Dementia

作　　者：王唯 卓益民 厚玉姣 石晓静 吉王琦 韩易 WANG Wei;ZHUO Yi-min;HOU Yu-jiao;SHI Xiao-jing;JI Wang-qi;HAN Yi(Department of Neurology,Naval Characteristic Medical Center of Chinese People's Liberation Army,Shanghai,200050,China;Department of Emergency,Naval Characteristic Medical Center of Chinese People's Liberation Army,Shanghai,200050,China)

机构地区：[1]中国人民解放军海军特色医学中心神经内科,上海200050 [2]中国人民解放军海军特色医学中心急诊科,上海200050

出　　处：《现代生物医学进展》2022年第1期99-102,112,共5页Progress in Modern Biomedicine

基　　金：上海市自然科学基金项目(15ZR1414600)。

摘　　要：目的:探讨盐酸多奈哌齐联合综合康复训练对老年痴呆患者认知功能、事件相关电位及血清脑源性神经营养因子(BDNF)、胰岛素样生长因子1(IGF-1)的影响。方法:选取2017年3月~2020年3月期间来我院接受治疗的120例老年痴呆患者,根据随机数字表法分为对照组(n=60,盐酸多奈哌齐治疗)和联合组(n=60,盐酸多奈哌齐联合综合康复训练治疗)。对比两组疗效,治疗前、治疗3个月后的认知功能评分、事件相关电位、血清BDNF和IGF-1水平变化,以及治疗期间不良反应发生情况。结果:联合组的临床总有效率为91.67%,高于对照组的70.00%(P<0.05)。两组治疗3个月后日常生活能力评估量表(ADL)、临床痴呆量表(CDR)评分降低,且联合组低于对照组(P<0.05);简易精神状态量表(MMSE)评分升高,且联合组高于对照组(P<0.05)。两组治疗3个月后N1潜伏期、P2潜伏期均缩短,P3波幅均升高,且联合组治疗3个月后P2潜伏期短于对照组,P3波幅高于对照组(P<0.05);两组治疗3个月后N1潜伏期比较未见统计学差异(P>0.05)。联合组治疗3个月后BDNF水平高于对照组(P<0.05);两组治疗3个月后IGF-1水平比较未见统计学差异(P>0.05)。对照组与联合组不良反应发生率对比无统计学差异(P>0.05)。结论:老年痴呆患者在盐酸多奈哌齐基础上联合综合康复训练,认知功能可得到明显改善,同时还可调节患者事件相关电位及血清BDNF、IGF-1水平。Objective: To investigate the effect of donepezil hydrochloride combined with comprehensive rehabilitation training on cognitive function, event-related potential and serum brain derived neurotrophic factor(BDNF), insulin-like growth factor-1(IGF-1) in patients with senile dementia. Methods: 120 patients with senile dementia who were treated in our hospital from March 2017 to March2020 were selected, they were divided into control group(n=60, donepezil hydrochloride treatment) and combination group(n=60,donepezil hydrochloride combined with comprehensive rehabilitation training treatment) according to random number table method. The efficacy, cognitive function scores, event-related potential and serum BDNF, IGF-1 before and 3 months after treatment, and the occurrence of adverse reactions during treatment of the two groups were compared. Results: The total effective rate of the combination group was 91.67%, which was higher than 72.92% of the control group(P<0.05). The scores of activities of daily living(ADL)assessment scale, clinical dementia rating(CDR) in both groups decreased, and the combination group was lower than the control group(P<0.05), the scores of Mini Mental State Scale(MMSE) increased,, and the combination group was higher than that of the control group(P<0.05). N1 latency and P2 latency shortened, P3 amplitude increased in the two groups at 3 months after treatment, and the P2 latency in the combination group was shorter than that in control group at 3 months after treatment, P3 amplitude was higher than that in control group(P<0.05), there was no significant difference in N1 latency between the two groups at 3 months after treatment(P>0.05). The level of BDNF in the combination group at 3 months after treatment was significantly higher than that in control group(P<0.05), there was no significant difference in IGF-1 level of the two groups at 3 months after treatment(P>0.05). There was no statistical difference in the incidence of adverse reactions between control group and combination group(P>

关 键 词：盐酸多奈哌齐 综合康复训练 老年痴呆 认知功能 事件相关电位 BDNF IGF-1 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]