摘要
目的探讨美金刚联合西酞普兰对阿尔茨海默病伴精神行为症状及认知功能的影响及其作用机制。方法选择2020年1月~2022年3月我院接诊的88例AD患者进行研究。采用随机数字表法将患者分为2组,每组各44例。对照组予盐酸美金刚片,观察组在此基础上加以氢溴酸西酞普兰片。比较2组患者临床疗效、精神行为症状、认知功能、细胞外信号调节酶(extracellular signalregulated kinase,ERK1/2)通路、环磷腺苷效应元件结合蛋白(cAMP-response element binding protein,CREB)、突触可塑性相关指标及不良反应发生情况。结果观察组总有效率为90.91%,高于对照组的75.00%(P<0.05)。治疗后两组患者简易精神状态检查表得分均高于治疗前,且观察组高于对照组;治疗后两组患者阿尔茨海默病病理行为评分、神经精神科问卷知情者版评分均低于治疗前,且观察组低于对照组(P<0.05)。治疗后两组患者ERK1/2、CREB水平均高于治疗前,且观察组高于对照组(P<0.05)。治疗后两组患者生长相关蛋白-43(growth-associated protein-43,GAP-43)、神经生长抑制因子A(neurite growth inhibitor-A,Nogo-A)表达灰度值均高于治疗前,且观察组均高于对照组(P<0.05)。对照组共出现6例(13.64%)不良反应,观察组共出现8例(18.18%)不良反应,两组差异无统计学意义(P>0.05)。结论美金刚联合西酞普兰治疗较单独使用美金刚可有效改善阿尔茨海默病患者精神行为症状及认知功能,其机制可能与激活ERK1/2、CREB信号通路,上调GAP-43、Nogo-A表达有关。
Objective To investigate the effect of memantine combined with citalopram on psychobehavioral symptoms and cognitive function in patients with Alzheimer's disease and its mechanism.Methods 88 AD patients from January 2020 to March 2022 were selected in this study.The patients were randomly divided into two groups with 44 patients in each group.The control group was given memantine hydrochloride tablets,and the observation group was given citalopram hydrobromide tablets on this basis.The clinical efficacy,psychobehavioral symptoms,cognitive function,extracellular signal-regulated kinase(ERK1/2),cAMP-response element binding protein(CREB),synaptic plasticity and adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 90.91%,higher than that of the control group 75.00%(P<0.05).The mini-mentalstate examination scores of patients in both groups after treatment were higher than those before treatment,and those in the observation group were higher than those in the control group;After treatment,the scores of behavioral pathology in Alzheimer's disease rating scale and Neuropsychiatric Inventory-Questionnaire in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).The ERK1/2 and CREB levels in the two groups after treatment were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).After treatment,the grayscale values of growth-associated protein-43(GAP 43)and neurite growth inhibitor-A(Nogo-A)expressions in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).There were 6 cases(13.64%)of adverse reactions in the control group,and 8 cases(18.18%)in the observation group.There was no significant difference between the two groups(P>0.05).Conclusion Memantine combined with citalopram can effectively improve the psychobehavioral s
作者
杜晓莉
何苏
王海燕
李佳敏
DU Xiaoli;HE Su;WANG Haiyan(Nanchong Mental Health Center Of Sichuan Province/Nanchong Second People's Hospital,Nanchong 637000,China)
出处
《国际精神病学杂志》
2023年第5期1040-1044,共5页
Journal Of International Psychiatry
关键词
美金刚
西酞普兰
阿尔茨海默病
精神行为症状
认知功能
Memantine
Citalopram
Alzheimer's Disease
Psychobehavioral Symptoms
Cognitive Function