银杏叶片联合多奈哌齐对阿尔茨海默病患者血浆β淀粉样蛋白及脑血管储备功能的影响

Ginkgo leaf tablets combined with donepezil on plasma amyloid-beta peptide and cerebrovascular reserve in Alzheimer's disease

目的探讨银杏叶片联合多奈哌齐对阿尔茨海黙病(Alzheimer’s disease,AD)患者血浆β淀粉样蛋白及脑血管储备(cerebrovascular reserve,CVR)功能的影响。方法选择2012年7月—2012年11月就诊于常德市第一中医院门诊的轻中度AD患者68例,最终纳入实验为60例,按随机数字表法分为对照组29例和治疗组31例。对照组给予安慰剂1片/次口服,3次/d;盐酸多奈哌齐5 mg口服,每晚1次。治疗组银杏叶片1片/次口服,3次/d;盐酸多奈哌齐5 mg口服,每晚1次。治疗前及治疗3个月后采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)及简易智能状态检查量表(mini mental state examination,MMSE)评分评估、测定血浆Aβ(1-40)、检测CVR功能。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗组治疗后MMSE、MoCa评分、血浆Aβ(1-40)、CVR[(21.16±2.02)、(21.94±2.94)分、(127.19±5.16)pmol/L、(22.19±3.78)%]与对照组[(19.72±3.03)、(20.48±2.44)分(130.34±6.70)pmol/L、(20.35±3.14)%]比较差异均有统计学意义(t=-2.173、-2.072、2.048、-2.052,均P<0.05)。结论银杏叶片联合多奈哌齐改善AD患者认知功能效应优于单用多奈哌齐,其机制可能与下调血浆Aβ(1-40)及改善CVR有关。

Objective To study the effects of ginkgo leaf tablets combined with donepezil on the level of plasma amyloid - beta peptide （Aβ） and cerebrovascular reserve （CVR）in patients with Alzheimer disease. Methods From July to No- vember in 2012, Sixty - eight patient with mild to moderate AD treated in our outpatient elinicwere selected and 60 cases were ultimately included. They were assigned to control group （ n = 29） and treatment group （ n = 31 ） with random number table. Control group was given placebo, one tablet,three times per day,and donepezil 5rag per night; and treatment group was given ginkgo leaf tablets, one tablet,three times per day and donepezil Stag per night. Both groups were evaluated for MoCA and MMSE scores, plasma level of Aβ （ 1 -40）, and CVR function before treatment and three months after treat- ment. T - test was used for measurement data, X2 test for count data, the result of P 〈 0.05 was considered statistically sig- nificant. Results After treatment,MMSE score was （21.16 ±2.02）, MoCA score （21.94 ±2.94）, plasma Aβ（ 1 -40） level （ 127. 19 ± 5. 16）pmol/L and CVR （22. 19 ± 3.78）% in treatment group; MMSE score was （ 19. 72 ±3.03 ）, MoCA score （20.48 ±2.44）, plasma A[3（ 1 -40） level （130.34 ±6.70） pmul/L and CVR （20.35 ±3.14）% in control group. There was significant difference between the two groups （t = -2. 173, -2. 072,2. 048 ± -2. 052, P 〈 0.05）. Conclusions Ginkgo leaf tablets combined with donepezil for is superior to donepezil in improving the cognitive function of AD pa- tiants, which may be related to down -regulating the level β plasma Aβ （1 -40）and improving ameliore CVR.