艾斯能和高压氧治疗老年期痴呆的临床疗效及艾斯能对患者血浆TGF-β、IGF-1及ICAM-1的影响

Clinical effect of Exelon and the high pressure oxygen uniting to treat the elderly dementia and influence of Exelon on plasma TGF-β,IGF-1 and ICAM-1 in patients with elderly dementia

目的探讨艾斯能和高压氧单独或联合治疗老年期痴呆的临床疗效，及艾斯能对患者血浆转化生长因子-β（TGF-β）、胰岛素样生长因子-1（IGF-1）及细胞间黏附分子-1（ICAM-1）的影响。方法将172例Alzheimer病（AD）、202例血管性痴呆（VD）患者随机分为艾斯能组、高压氧组、联合治疗组和吡拉西坦组，比较治疗前后各组患者的简易精神状态检查量表（MMSE）评分。艾斯能组在治疗前后监测血中TGF-β、ICAM-1及IGF-1水平。结果治疗后AD和VD组中艾斯能组、高压氧组、联合治疗组MMSE评分均有极显著改善（均P〈0．01）；并极显著优于吡拉西坦组（均P〈0．01），联合治疗组优于艾斯能组和高压氧组（P〈0．05—0．01），艾斯能组优于高压氧组（均P〈0．05）；艾斯能组在治疗后血TCF．B和IGF．1水平显著上升，ICAM-1水平显著下降（均P〈0．01）。结论艾斯能治疗可明显改善AD与VD患者的MMSE评分；提高TGF-β和ICF-1水平，降低ICAM-1水平；与高压氧联合应用可提高其疗效，其中艾斯能疗效优于高压氧单用。

Objective To investigate the clinical effect of Exelon and the high pressure oxygen uniting to treat the old-age period of dementia and influence of Exelon on plasma transforming growth factor β（ TGF-β）, insulin-like growth factor 1 （ IGF-1 ） and intercellular adhesion molecule-1 （ ICAM-1 ） in patients with elderly dementia. Methods 172 cases with Alzheimer＇s diseases （AD） and 202 cases with vascular dementia （VD） were randomly divided into Exelon group, high pressure oxygen group, uniting group （taking Exelon and doing the high pressure oxygen together） and piracetam group. The MMSE scores were graded before and after treatment. TGF-β, IGF-1 and ICAM- 1 were detected in Exelon group before and after treatment. Results MMSE scores had improved in Exelon group, high pressure oxygen group and uniting group after the treatment in AD group and VD group （ all P 〈0. 01 ） ;MMSE scores of Exelon group, high pressure oxygen group and uniting group had improved than that of in piracetam group （ all P 〈 0. 01 ） ; MMSE score of uniting group was more improvement than that of Exelon group and high pressure oxygen group （ P 〈 0. 05 ~ 0. 01 ） , while MMSE score of Exelon group was more improvement than that of high pressure oxygen group （ all P 〈 0. 05 ）. There were TGF-β, IGF-1 increasing and ICAM-1 decreasing after Exelon treatment （ all P 〈 0. 01 ）. Conclusions Exelon is of great benefit to MMSE score improvement of AD and VD patients, combined with high pressure oxygen treatment enhancing curative effect. Exelon can also increase TGF-β, IGF-1 and decrease ICAM-1 in patients with dementia, which can be useful for controlling and recovering patients from dementia.