重复经颅磁刺激联合认知训练对阿尔茨海默病患者血清炎症因子及T淋巴细胞亚群的影响  

Study on serum inflammatory factors and T lymphocyte subsets in Alzheimer忆s disease by repetitive transcranial magnetic stimulation combined with cognitive training

作　　者：董靖雯 杜玉洁 王理鑫 陈淅泠[1] DONG Jingwen;DU Yujie;WANG Lixin;CHEN Xiling(Department of Geriatrics,the Second Affiliated Hospital of Zhengzhou University,Henan Province,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院老年医学科,河南郑州450014

出　　处：《中国当代医药》2023年第21期8-13,共6页China Modern Medicine

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合计算机认知训练(CCT)对阿尔茨海默病(AD)患者血清炎症因子及T淋巴细胞亚群的影响。方法选取2020年10月至2022年5月在郑州大学第二附属医院治疗且符合纳入标准的76例轻度AD患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,每组各38例。治疗组患者采用rTMS联合CCT治疗,对照组患者采用经颅磁伪刺激联合CCT治疗。治疗后采用简易智能精神状态量表(MMSE)及阿尔茨海默病认知功能评定量表(ADAS-COG)比较两组患者治疗前后的认知功能,并比较两组患者治疗前后的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、杀伤T细胞(TC)、辅助T细胞(TH)及调节性T细胞(Tregs)水平。结果治疗组患者治疗后的IL-6、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。治疗组患者治疗后的TH、Tregs水平高于对照组,差异有统计学意义(P<0.05)。治疗组患者治疗后的ADAS-COG评分低于对照组,MMSE评分高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者的IFN-γ、TC水平比较,差异无统计学意义(P>0.05)。治疗后,治疗组患者的IL-6、TNF-α水平低于本组治疗前,对照组患者的IL-6水平低于本组治疗前,差异有统计学意义(P<0.05)。治疗后,治疗组患者的TH、Tregs水平高于本组治疗前,差异有统计学意义(P<0.05)。治疗后,两组患者的ADAS-COG评分均低于本组治疗前,MMSE评分均高于本组治疗前,差异有统计学意义(P<0.05)。结论rTMS联合CCT能够降低AD患者血清IL-6、TNF-α,提高血清TH、Tregs水平,改善认知功能。Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)combined with computerized cognitive training(CCT)on serum inflammatory factors and T lymphocyte subsets in Alzheimer's disease(AD).Methods A total of 76 patients with mild AD who met the inclusion criteria and treated in the Second Affiliated Hospital of Zhengzhou University from October 2020 to May 2022 were selected as the study objects.They were divided into treatment group and control group by random number method,with 38 patients in each group.Patients in the treatment group were treated with rTMS combined with CCT,and patients in the control group were treated with transcranial magnetic pseudo-stimulation combined with CCT.After treatment,the cognitive functions of the two groups were compared by the mini-mental state examination(MMSE)and the Alzheimer's disease assessment scale-cognition(ADAS-COG).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),killer T cells(TC),helper T cells(TH)and regulatory T cells(Tregs)before and after treatment were compared between the two groups.Results The levels of IL-6 and TNF-αin the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).TH and Tregs levels in the treatment group were higher than those in the control group after treatment,and the differences were statistically significant(P<0.05).After treatment,the ADAS-COG score of the treatment group was lower than that of the control group,and the MMSE score was higher than that of the control group,with statistical significances(P<0.05).There were no significant differences in IFN-γand TC levels between the two groups after treatment(P>0.05).After treatment,the levels of IL-6 and TNF-αin the treatment group were lower than those before treatment,and the level of IL-6 in the control group was lower than those before treatment,the differences were statistically significant(P<0.05).After treatment,TH and Tregs levels in the treatm

关 键 词：重复经颅磁刺激 认知训练 阿尔茨海默病 认知功能 阿尔茨海默病认知功能评定量表 炎症因子 T淋巴细胞亚群 

分 类 号：R749.16[医药卫生—神经病学与精神病学]