重复经颅磁刺激联合多奈哌齐对阿尔茨海默病患者认知功能和血清炎症因子的影响  

Effect of repetitive transcranial magnetic stimulation combined with donepezil on cognitive function and serum inflammatory factors in patients with Alzheimer’s disease

作　　者：王爱花[1] 徐锐[1] 林荫[1] WANG Aihua;XU Rui;LIN Yin(Department of Mental Rehabilitation,Hainan Anning Hospital,Haikou 570206,China)

机构地区：[1]海南省安宁医院精神康复科,海口570206

出　　处：《临床与病理杂志》2023年第6期1199-1205,共7页Journal of Clinical and Pathological Research

基　　金：海南省卫生健康行业科研项目(21A200382)。

摘　　要：目的:探究重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合多奈哌齐对阿尔茨海默病(Alzheimer’s disease,AD)患者认知功能和血清炎症因子的影响。方法:选取2019年3月至2021年10月海南省安宁医院收治的100例AD患者,按随机数字表法随机分为对照组和观察组,每组50例。对照组予以伪刺激+多奈哌齐治疗,观察组予以rTMS+多奈哌齐治疗。比较2组临床疗效及治疗前后简易精神状态检查量表(Mini-Mental State Examination Scale,MMSE)、AD认知评定量表(AD Cognitive Assessment Scale,ADAS-Cog)、行为记忆量表(Behavioral Memory Scale,BRMT)、神经精神问卷(Neuropsychiatric Inventory,NPI)、日常生活能力量表(Activity of Daily Living Scale,ADL)、社会功能活动问卷(Social Function Activity Questionnaire,FAQ)及血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、淀粉样β蛋白1-42(amyloidβprotein 1-42,Aβ_(1-42))水平。结果:观察组临床总有效率明显高于对照组(P<0.05)。与对照组相比,观察组治疗后MMSE、BRMT评分均明显更高,ADAS-Cog、NPI、ADL、FAQ评分则明显更低(均P<0.05)。观察组血清IL-6、TNF-α、Aβ_(1-42)水平均明显低于对照组(均P<0.05)。结论:rTMS联合多奈哌齐治疗AD疗效显著,可有效提高患者认知功能,缓解精神行为症状,改善日常生活能力,抑制炎症反应。Objective:To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)combined with donepezil on cognitive function and serum inflammatory factors in patients with Alzheimer’s disease(AD).Methods:A total of 100 AD patients admitted to Hainan Anning Hospital from March 2019 to October 2021 were selected as research subjects and randomly divided into a control group and an observation group according to the random number table method,with 50 cases in each group.The control group was treated with pseudostimulation and donepezil,and the observation group was treated with rTMS and donepezil.The clinical efficacy and the levels of Mini-Mental State Examination Scale(MMSE),AD Cognitive Assessment Scale(ADAS-Cog),Behavioral Memory Scale(BRMT),Neuropsychiatric Questionnaire(NPI),Activity of Daily Living Scale(ADL),Social Function Activity Questionnaire(FAQ),serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and amyloidβprotein 1-42(Aβ_(1-42))before and after treatment were compared between the 2 groups.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Compared with the control group,the scores of MMSE and BRMT in the observation group were significantly higher after the treatment(both P<0.05).The scores of ADAS-Cog,NPI,ADL,FAQ were significantly lower(all P<0.05).The serum levels of IL-6,TNF-α,and Aβ_(1-42) in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion:The efficacy of rTMS combined with donepezil in the treatment of AD is remarkable,which can effectively improve the cognitive function of patients,alleviate mental and behavioral symptoms,improve daily living ability,and inhibit inflammatory response.

关 键 词：重复经颅磁刺激 多奈哌齐 阿尔茨海默病 认知功能 炎症因子 

分 类 号：R749.16[医药卫生—神经病学与精神病学]