3R疗法对阿尔茨海默病患者认知功能和血浆β淀粉样蛋白_(1-42)的影响

Effect of 3R therapy on cognitive function and human plasma amyloid protein β_(1-42) in patients with Alzheimer's disease

目的评价3R疗法对轻、中度阿尔茨海默病患者认知功能和血浆β淀粉样蛋白_(1-42)(Aβ_(1-42))的影响。方法选择轻、中度阿尔茨海默病患者34例,随机分为2组,每组17例。对照组给予药物常规治疗,治疗组在药物常规治疗基础上,采用3R疗法进行认知功能训练。测定血浆Aβ_(1-42),并进行神经心理学指标检查:简易智能状态检查量表、日常生活活动能力量表(ADL)、社会功能活动调查(FAQ)、神经精神量表(NPI)以及事件相关电位P300的基线评定,在开始实施训练后的第3、6个月时,分别对患者进行各项指标的评定与分析。结果治疗组经过3、6个月的3R治疗后,ADL、FAQ、NPI评分较治疗前明显减低,且明显低于对照组(P<0.05,P<0.01);P300潜伏期明显缩短,波幅明显增加(P<0.01);治疗组经过6个月的3R治疗后,血浆Aβ_(1-42)含量较治疗前明显下降,且较对照组明显下降(p<0.05)。结论 3R疗法能有效提高阿尔茨海默病患者生活自理能力、社会活动能力,从而延缓认知功能减退;3R治疗后,认知功能改善可能与血浆Aβ_(1-42)含量变化有关。

Objective To assess the effect of 3R therapy on cognitive function and human plasma amyloid protein β1-42 in patients with mild or moderate Alzheimer＇s disease（AD）. Methods Thirty-four patients with mild or moderate AD were randomly divided into treatment group and control group. Patients in control group received routine drug treatment and those in treatment group underwent routine drug treatment plus 3R therapy. Their baseline plasma amyloid protein β1-42levels were measured and their neuropsychological parameters were detected with Mini Mental State Scale, Activity of Daily Living （ADL） Scale, Social Functional Activity Questionnaire （FAQ） ,Neuropsychiatric lnventory（NP1） Scale and Event-Related Potential P300, and analyzed 3 and 6 months after treatment. Results The ADL,FAQ and NPI scores were significantly lower, while the latency of P300 was significantly shorter and the wave amplitude of P300 was significantly higher in treatment group than in control group 3 and 6 months after treatment（P〈0.05, P〈0.01）. The plasma amyloid protein β1-42 level was significantly lower in treatment group than in control group 6 months after treatment（P〈0.05）. Conclusion 3R therapy can effectively improve the daily living and social activity of AD patients, thus alleviating their cognitive decline. Improved cognitive function after 3R therapy may be related with the plasma amyloid protein β1-42 level.