事件相关电位量化评估银杏提取物注射液对血管性痴呆患者的治疗效应

Quantitative evaluation of the therapeutic effect of ginkgo biloba extract for vascular dementia patients with event related potential

目的:应用银杏提取物(ginkgobilobaextract,EGb)治疗血管性痴呆(vasculardementia,VD),并在治疗前后通过与认知功能相关的事件相关电位(event-relatedpotentials,ERP)及简易智能状态评定量表(MMSE)测定EGb改善VD患者认知功能的疗效。方法:2000-03/2004-09福建省老年医院神经内科住院血管性痴呆患者63例,随机分为治疗组43例,对照组20例。治疗组银杏提取物注射液30mL加入50g/L葡萄糖液250mL静脉滴注,对照组丹参注射液250mL静脉滴注,1次/d,14d为1个疗程,共2个疗程。治疗前后MMSE及事件相关电位测定。结果:治疗组治疗前后MMSE评分[小学患者:治疗前(17.56±1.89)分,治疗后(19.43±2.1)分,中学患者:治疗前(21.03±1.15)分,治疗后(21.93±2.95)分]差异有显著性意义(t=2.653,2.8443,P<0.05),治疗组治疗前后ERP靶N1,P2潜伏期差异无显著性意义,治疗组治疗前后N2潜伏期[治疗前(275.24±49.08)ms,治疗后(252.39±26.24)ms]有显著性意义(t=2.6927,P<0.05),P3潜伏期[治疗前(402.91±22.48)ms,治疗后(385.06±14.40)ms]及P3波幅[治疗前(3.58±1.41)μV,治疗后(4.53±1.26)μV]有非常显著性意义(t=3.4525,2.9466,P<0.01)。治疗组与对照组治疗后MMSE评分比较差异无显著性意义,治疗组与对照组治疗后ERP靶N1。

AIM:To treat vascular dementia(VD) with ginkgo biloba extract(EGb), and assess the effect of EGb for improving cognitive function of VD patients with event related potentials(ERP) and mini mental state examination(MMSE) before and after treatment. METHODS:From March 2000 to September 2004,63 VD patients hospitalized in the Department of Neurology, Senile Hospital of Fujian Province were enrolled and then randomized into treatment group(n=43) and control group(n=20).The subjects in the treatment group and control group were intravenously injected with 250 mL of 50 g/L glucose containing 30 mL of EGb and 250 mL of danshen solution once a day,respectively.The duration of treatment was 2 courses(14 days as a course).The therapeutic effect was measured with ERP and MMSE. RESULTS:The MMSE scores before and after treatment were 17.56±1.89 and 19.43±2.1 for the patients with the education level of primary school, 21.03±1.15 and 21.93±2.95 for the patients with high middle school, respectively.There were significant differences in the two groups before and after treatment(t=2.653, 2.844 3,P < 0.05). In the treatment group,no significant difference was found in the N1 and P2 latencies of ERP before and after treatment; however, there was a significant difference in the latencies of N2[(275.24±49.08)ms vs (252.39±26.24) ms,t=2.692 7,P< 0.05],and very significant difference in the latencies[(402.91±22.48) ms vs(385.06±14.40)ms]and amplitudes[(3.58±1.41)μV vs(4.53 ±1.26) μV]of P3 before and after treatment(t=3.452 5, 2.946 6, P< 0.01).After treatment, no significant differences occurred in the MMSE scores and N1 and P2 of ERP between the treatment and control groups, but there were significant differences in the latencies of N2 and P3 and amplitude of P3 between the two groups(P< 0.05). CONCLUSION:EGb for treating VD can improve the intelligence and memory of VD patients to a certain extent, and ERP objectively reflects the changes in the cognitive function of patients.