度洛西汀联合多奈哌齐对慢性血管性痴呆患者的效果及对血清5-羟色胺、神经元特异性烯醇化酶水平的影响  

Effect of duloxetine combined with donepezil in patients chronic vascular dementia and its impact on serum serotonin and neuron specific enolase levels

作　　者：文启琴[1] 钟书铭[1] 李佑辉[1] 符卫仙[1] 黄凤霞[1] WEN Qiqin;ZHONG Shuming;LI Youhui(The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,China)

机构地区：[1]广州医科大学附属脑科医院,广州510370

出　　处：《国际精神病学杂志》2024年第2期481-485,共5页Journal Of International Psychiatry

摘　　要：目的探讨度洛西汀联合多奈哌齐治疗慢性血管性痴呆患者的效果及对血清5-羟色胺(5-hydroxytryptamine,5-HT)、神经元特异性烯醇化酶(neuron specific enolase,NSE)水平的影响。方法选取2021年4月~2023年4月医院收治的98例慢性血管性痴呆患者作为研究对象,依照随机数字表法分为研究组和对照组。对照组采用多奈哌齐治疗,研究组采用度洛西汀联合多奈哌齐治疗。比较两组患者认知功能,日常生活能力,情绪状态,临床疗效,血清5-HT、NSE水平及不良反应。结果治疗3个月后,两组患者简易智力状况检查表(Mini-mental state examination,MMSE)评分、生活质量(Activity of daily living,ADL)评分均升高(P<0.05),且研究组MMSE评分、ADL评分均高于对照组(P<0.05);治疗3个月后,2组患者汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分均降低(P<0.05),且研究组HAMA评分、HAMD评分均低于对照组(P<0.05);治疗3个月后,研究组总有效率高于对照组(P<0.05);治疗3个月后,2组患者血清5-HT水平均升高(P<0.05),且研究组血清5-HT水平高于对照组(P<0.05),2组患者血清NSE水平均降低(P<0.05),且研究组血清NSE水平低于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论度洛西汀联合多奈哌齐用于治疗慢性血管性痴呆患者可以减轻认知障碍,改善生活质量,并且可以调节血清5-HT、NSE水平,疗效确切,安全可靠。Objective To explore the efficacy of duloxetine combined with donepezil in the treatment of chronic vascular dementia and its impact on serum levels of 5-hydroxytryptamine(5-HT)and neuron specific enolase(NSE).Methods 98 patients with chronic vascular dementia admitted to the hospital from April 2021 to April 2023 were selected as the research subjects and were randomly divided into study group and control group.The control group was treated with donepezil,while the study group was treated with duloxetine combined with donepezil.The cognitive function,daily living ability,emotional state,clinical efficacy,serum 5-HT,NSE levels,and adverse reactions of two groups of patients were compared.Results After 3 months of treatment,the mini-mental state examination(MMSE)and activity of daily living(ADL)scores of both groups of patients were increased(P<0.05),and the MMSE score and ADL score of the study group were higher than those of the control group(P<0.05).After 3 months of treatment,the Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)scores of both groups of patients were decreased(P<O.05),and the HAMA and HAMD scores of the study group were lower than those of the control group(P<0.05).After 3 months of treatment,the total effective rate of the study group was higher than that of the control group(P<0.05).After 3 months of treatment,the serum 5-HT levels in both groups of patients increased(P<0.05),and the serum 5-HT levels in the study group were higher than those in the control group(P<0.05).The serum NSE levels in both groups of patients decreased(P<0.05),and the serum NSE levels in the study group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Duloxetine combined with donepezil in the treatment of chronic vascular dementia patients can alleviate cognitive impairment,improve quality of life,and regulate serum 5-HT and NSElevels.

关 键 词：度洛西汀 多奈哌齐 慢性血管性痴呆 5-羟色胺 神经元特异性烯醇化酶 

分 类 号：R743[医药卫生—神经病学与精神病学]