丁苯酞联合尼麦角林治疗非痴呆型血管性认知功能障碍患者的疗效及作用机制探讨  

The efficacy and mechanism of butylphthalide combined with nimergoline in the treatment of non⁃dementia type vas⁃cular cognitive impairment patients

作　　者：陶伟 许光霞 王爱滨 张卓 孟庆玲 刘啸 张子斌 Tao Wei;Xu Guangxia;Wang Aibing;Zhang Zhuo;Meng Qingling;Liu Xiao;Zhang Zibin(The Second Hospital of Liaocheng Affiliated to Shandong First Medical University,Shandong Province,Liaocheng 252600,China)

机构地区：[1]山东第一医科大学附属聊城二院神经内科一病区,山东聊城252600

出　　处：《疑难病杂志》2023年第6期620-624,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：山东省医药卫生科技发展计划项目(2014WS0306)。

摘　　要：目的探讨丁苯酞联合尼麦角林治疗非痴呆型血管性认知功能障碍(VCIND)的临床疗效及可能作用机制。方法选择2018年7月—2021年2月山东第一医科大学附属聊城二院神经内科一病区收治的VCIND患者107例为研究对象,采用随机数字表法分为试验组54例、对照组53例。在常规治疗及认知功能训练的同时,对照组给予尼麦角林片治疗,试验组给予丁苯酞联合尼麦角林治疗。治疗6个月,比较2组认知功能、血清炎性因子、氧化应激、神经相关生长因子等指标。结果治疗6个月后,试验组患者简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组(t=6.117,4.018,P<0.001)。血清白介素⁃6(IL⁃6)、C⁃反应蛋白(CRP)、肿瘤坏死因子⁃α(TNF⁃α)水平低于对照组(t=4.216,2.863,4.351,P<0.05)。丙二醛(MDA)水平低于对照组,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH⁃Px)水平高于对照组(t=3.857,10.196,5.876,P<0.001)。血清脑源性神经生长因子(BDNF)、血管内皮生长因子(VEGF)、胰岛素样生长因子⁃1(IGF⁃1)水平高于对照组(t=5.176,8.466,3.831,P<0.001)。结论丁苯酞联合尼麦角林治疗有助于改善VCIND患者认知功能,可能与拮抗炎性反应、调节神经相关生长因子等因素有关。Objective To explore the clinical efficacy and possible mechanisms of butylphthalide combined with nimergoline in the treatment of non⁃dementia type vascular cognitive impairment(VCIND).Methods One hundred and sev⁃en VCIND patients admitted to the Neurology Department of Liaocheng Second Hospital,Shandong First Medical University from July 2018 to February 2021 were selected as the study subjects.They were randomly divided into an experimental group of 54 cases and a control group of 53 cases using a random number table method.In addition to routine treatment and cognitive function training,the control group was treated with nimergoline tablets,while the experimental group was treated with butylphthalide combined with nimergoline.After 6 months of treatment,two groups were compared in terms of cognitive function,serum inflammatory factors,oxidative stress,and nerve related growth factors.Results After 6 months of treat⁃ment,the scores on the Mini Mental State Scale(MMSE)and Montreal Cognitive Assessment Scale(MoCA)in the experi⁃mental group were higher than those in the control group(t=6.117,4.018,P<0.001).The level of serum interleukin⁃6(IL⁃6),C⁃reactive protein(CRP),and tumor necrosis factor⁃α(TNF⁃α)were lower than that of the control group(t=4.216,2.863,4.351,P<0.05).The level of malondialdehyde(MDA)was lower than that of the control group,and the levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH⁃Px)were higher than that of the control group(t=3.857,10.196,5.876,P<0.001).The serum levels of brain derived nerve growth factor(BDNF),vascular endothelial growth factor(VEGF),and in⁃sulin⁃like growth factor⁃1(IGF⁃1)were higher in the control group than in the control group(t=5.176,8.466,3.831,P<0.001).Conclusion The combination of butylphthalide and nimergoline treatment can help improve cognitive function in VCIND patients,which may be related to factors such as antagonizing inflammatory reactions and regulating nerve related growth factors.

关 键 词：非痴呆型血管性认知功能障碍 丁苯酞 尼麦角林 炎性因子 氧化应激 神经生长因子 

分 类 号：R743.9[医药卫生—神经病学与精神病学]