摘要
目的:探讨尼莫地平联合高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,r TMS)治疗皮层下非痴呆型血管性认知障碍的临床效果。方法:选取2018年6月至2019年6月于长沙市第三医院接受治疗的皮层下非痴呆型血管性认知障碍患者116例,采用随机数字表法分为r TMS治疗组、联合治疗组,每组58例。r TMS治疗组患者进行r TMS治疗,联合治疗组患者在r TMS治疗基础上联合应用尼莫地平。观察两组患者的蒙特利尔认知量表(Montreal cognitive assessment,MoCA)评分、Barthel评分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)及汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分;比较两组患者的血清S100β蛋白、神经元特异性烯醇化酶(NSE)、胰岛素样生长因子1(IGF-1)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂(LPO)及丙二醛(MDA)水平的差异;观察两组患者的临床疗效。结果:治疗后,联合治疗组患者的MoCA评分、Barthel评分均明显高于r TMS治疗组;联合治疗组患者的血清S100β蛋白、NSE水平明显低于r TMS治疗组,IGF-1水平明显高于r TMS治疗组,上述差异均有统计学意义(P<0.05)。治疗后,联合治疗组患者的血清TNF-α、IL-1β及IL-6水平明显低于r TMS治疗组;联合治疗组患者的GSH-Px水平明显高于r TMS治疗组,LPO、MDA水平明显低于r TMS治疗组,上述差异均有统计学意义(P<0.05)。治疗后,与r TMS治疗组比较,联合治疗组患者的HAMA评分、HAMD评分明显更低,差异均有统计学意义(P<0.05)。联合治疗组患者的总有效率高达89.66%(52/58),明显高于r TMS治疗组的75.86%(44/58),差异有统计学意义(P<0.05)。结论:采用尼莫地平联合r TMS对皮层下非痴呆型血管性认知障碍患者进行治疗,能够提高患者的认知功能、日常生活能力,调控血清S100β蛋白、NSE及IGF-1水平,减轻脑组织炎症反应,提高�
OBJECTIVE:To probe into the treatment effects of nimodipine combined with high frequency repetitive transcranial magnetic stimulation(r TMS)in the treatment of patients with subcortical non-dementia vascular cognitive impairment.METHODS:Totally 116 patients with subcortical non-dementia vascular cognitive impairment admitted into the Third Hospital of Changsha from Jun.2018 to Jun.2019 were extracted to be divided into the r TMS treatment group and the combination treatment group via the random number table,with 58 cases in each group.The r TMS treatment group was treated with r TMS,while the combination treatment group received nimodipine on the basis of r TMS.Montreal cognitive assessment(MoCA)score,Barthel score,Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)score of two groups were observed.The serum S100βprotein,neuron specific enolase(NSE),insulin-like growth factor 1(IGF-1),tumor necrosis factorα(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),glutathione peroxidase(GSH-Px),lipid peroxide(LPO)and malondialdehyde(MDA)of two groups were compared.The clinical efficacy of two groups was analyzed.RESULTS:After treatment,MoCA score and Barthel score of patients in the combination treatment group were significantly higher than those in the r TMS treatment group;the serum levels of S100βprotein and NSE in the combination treatment group were significantly lower than those in the r TMS treatment group,and the level of IGF-1 was significantly higher than that in the r TMS treatment group,with statistically significant difference(P<0.05).After treatment,the serum levels of TNF-α,IL-1βand IL-6 in the combination treatment group were significantly lower than those in the r TMS group;the levels of GSH-Px in the combination treatment group were significantly higher than those in the r TMS group,while the levels of LPO and MDA in the combination treatment group were significantly lower than those in the r TMS treatment group,with statistically significant difference(P<0.05).Compared with the r TMS
作者
黄芳
丁玲
陈旭
HUANG Fang;DING Ling;CHEN Xu(Dept.of Neurology,the Third Hospital of Changsha,Hunan Changsha 410000,China)
出处
《中国医院用药评价与分析》
2021年第2期155-159,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
长沙市科技计划项目(No.kq1706005)。
关键词
高频重复经颅磁刺激
尼莫地平
非痴呆型血管性认知障碍
认知功能
High frequency repetitive transcranial magnetic stimulation
Nimodipine
Non-dementia vascular cognitive impairment
Cognitive function
