普拉克索、美多巴及运动疗法对帕金森病患者认知功能、情感症状及脑干功能的影响  

Effects of Pramipexole, Mdopa and Exercise Therapy on Cognitive Function,Affective Symptoms and Brain Stem Function in Patients of Parkinson’s Disease

作　　者：刘海涛 侯国勇 张君君 LIU Haitao;HOU Guoyong;ZHANG Junjun(Department of Neurology,Pingmei Shenma Medical Group General Hospital,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院神经内科,河南平顶山467000

出　　处：《河南医学研究》2024年第23期4331-4336,共6页Henan Medical Research

摘　　要：目的探讨普拉克索、美多巴及运动疗法对帕金森病(PD)患者认知功能、情感症状及脑干功能的影响。方法选取2021年1月至2023年1月平煤神马医疗集团总医院收治的90例PD患者为研究对象,随机分为对照A组、对照B组、联合组,每组30例。对照A组接受普拉克索、运动疗法治疗,对照B组接受美多巴、运动疗法治疗,联合组接受普拉克索、美多巴及运动疗法治疗。对比3组临床疗效、步态、运动功能[统一帕金森病评价量表-Ⅲ(UPDRS-Ⅲ)、Berg平衡量表(BBS)]、认知功能[蒙特利尔认知评估量表(MoCA)]、情感症状[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]及脑干功能(波潜伏期、波峰间潜伏期)。对比3组治疗前后血清神经递质[脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)、去甲肾上腺素(NE)]、微小RNA-124(miR-124)、胰岛素样生长因子-1(IGF-1)水平及不良反应。结果联合组总有效率高于对照A组、对照B组(P<0.05);治疗后,联合组步态、运动功能、脑干功能改善幅度大于对照A组、对照B组(P<0.05);治疗后,联合组MoCA评分高于对照A组、对照B组,HAMA、HAMD评分低于对照A组、对照B组(P<0.05);治疗后,联合组血清BDNF、5-HT、NE、miR-124、IGF-1水平高于对照A组、对照B组(P<0.05),且对照A组、对照B组不同指标比较,差异无统计学意义(P>0.05);3组均无明显不良反应。结论普拉克索、美多巴联合运动疗法治疗PD的效果确切,可改善运动功能、脑干功能,纠正异常情感状态,提高认知功能,可能通过调控miR-124/IGF-1通路发挥作用。Objective To investigate the effects of pramipexole,mdopa and exercise therapy on cognitive function,emotional symptoms and brain stem function in patients of Parkinson’s disease(PD).Methods A total of 90 patients with PD admitted to Pingmei Shenma Medical Group General Hospital from January 2021 to January 2023 were selected as research objects and randomly divided into control group A,control group B and combination group,with 30 cases in each group.Control group A was treated with pramexole and exercise therapy,control group B was treated with mdopa and exercise therapy,and combination group was treated with pramexole,mdopa and exercise therapy.The clinical efficacy,gait,motor function[UPDRS-Ⅲ(UPDRS-Ⅲ),Berg balance scale(BBS)],cognitive function[Montreal cognitive assessment scale(MoCA)],emotional symptoms[Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)]and brain stem function(wave latency,peak latency)of the 3 groups were compared.The levels of serum neurotransmitters[brain-derived neurotrophic factor(BDNF),5-hydroxytryptamine(5-HT),norepinephrine(NE)],microRNA-124(miR-124)and insulin-like growth factor-1(IGF-1)before and after treatment were compared in the 3 groups,and the adverse reaction was compared between the 3 groups.Results The total effective rate of combined group was higher than that of control group A and control group B(P<0.05).After treatment,the improvement of gait,motor function and brainstem function in combination group was greater than that in control group A and control group B(P<0.05).After treatment,MoCA scores in combination group were higher than those in control group A and control group B,and HAMA and HAMD scores were lower than those in control group A and control group B(P<0.05).After treatment,the levels of serum BDNF,5-HT,NE,miR-124 and IGF-1 in combination group were higher than those in control group A and control group B(P<0.05),and there was no statistical significance in different indexes between control group A and control group B(P>0.05).There were no s

关 键 词：帕金森病 普拉克索 美多巴 运动疗法 认知功能 脑干功能 

分 类 号：R742.5[医药卫生—神经病学与精神病学]