HF-rTMS联合盐酸美金刚与尼莫地平治疗血管性痴呆的疗效及对内皮细胞功能的影响  

Therapeutic effect of HF-rTMS combined with memantine hydrochloride and nimodipine in the treatment of vascular dementia and its impact on endothelial cell function

作　　者：李翠翠 朱应超 李静 LI Cuicui;ZHU Yingchao;LI Jing(People’s Hospital Affiliated to Shandong First Medical University,Ji’nan 271199,China)

机构地区：[1]山东第一医科大学附属人民医院,山东济南271199

出　　处：《中国实用神经疾病杂志》2025年第1期33-36,共4页Chinese Journal of Practical Nervous Diseases

基　　金：济南市卫生健康委员会科技计划项目(编号:2021-1-10)。

摘　　要：目的探究高频重复经颅磁刺激(HF-rTMS)结合盐酸美金刚、尼莫地平治疗血管性痴呆的疗效及对内皮细胞功能的影响。方法将山东第一医科大学附属人民医院神经内科2022-02—2023-02收治的68例血管性痴呆患者纳入研究,随机分为对照组与研究组,对照组采用盐酸美金刚与尼莫地平治疗,研究组在对照组的基础上增加HF-rTMS治疗,对比2组临床疗效(包括治疗前后认知功能、日常生活能力)及对内皮细胞功能[内皮素(ET1)、可溶性细胞间黏附分子1(sICAM-1)]的影响。结果治疗前,2组简易精神状态量表(MMSE)评分、日常生活能力(ADL)评分差异无统计学意义(t=0.646、0.080,P=0.521、0.936),治疗后2组评分均有所提高,研究组MMSE、ADL评分均高于对照组(t=4.755,P<0.001;t=6.224,P<0.001)。治疗前,2组ET1、sICAM-1水平差异无统计学意义(t=0.233、0.344,P=0.817、0.732),治疗后2组水平均有所降低,研究组ET1、sICAM-1水平均低于对照组(t=4.781,P<0.001;t=2.400,P=0.019)。研究组2例(5.89%)患者在HF-rTMS治疗后出现头晕症状,后调整刺激强度症状消失。结论血管性痴呆患者经HF-rTMS联合盐酸美金刚与尼莫地平治疗后,认知功能、日常生活能力及内皮细胞功能均得以改善,联合治疗的安全性较高。Objective To investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation(HF-rTMS)combined with memantine hydrochloride and nimodipine in the treatment of vascular dementia and the effect on endothelial cell function.Methods Sixty-eight patients with vascular dementia admitted to the Department of Neurology,Affiliated People’s Hospital of Shandong First Medical University from February 2022 to February 2023 were included in this study and were randomly divided into control group and study group.The control group was treated with memantine hydrochloride and nimodipine.The study group added HF-rTMS treatment on the basis of the control group,and the clinical efficacy(including cognitive function and daily living ability before and after treatment)and the influence on endothelial cell function(endothelin(ET1),soluble intercellular adhesion molecule-1(sICAM-1))of the two groups were compared.Results Before treatment,there was no significant difference on MMSE score and ADL score between the two groups(t=0.646,0.080;P=0.521,0.936).After treatment,the scores of the two groups were improved,MMSE and ADL scores in the study group were higher than those in the control group(t=4.755,P<0.001;t=6.224,P<0.001).Before treatment,there was no statistical significance in the levels of ET1 and sICAM-1 between the two groups(t=0.233,0.344;P=0.817,0.732),but after treatment,the levels of ET1 and sICAM-1 in the study group were lower than those in the control group(t=4.781,P<0.001;t=2.400,P=0.019).In the study group,2 patients(5.89%)experienced dizziness after HF-rTMS treatment,and the symptoms disappeared after adjusting the stimulation intensity.Conclusion HF-rTMS combined with memantine hydrochloride and nimodipine can improve cognitive function,daily living ability and endothelial cell function in patients with vascular dementia,and the combination therapy is safe.

关 键 词：血管性痴呆 高频重复经颅磁刺激 盐酸美金刚 尼莫地平 内皮细胞功能 

分 类 号：R277.6[医药卫生—中医学]