小檗碱对老年痴呆早期防治的研究

A study of berberin in preventing and treating preclinical dementia in the aged

目的 为研究小檗碱对老年痴呆临床前期人群的防治意义及机制。 方法 采用系列〔痴呆简易筛查量表 (BSSD)、视觉保持试验 (VRT)、数字广度测验 (DS)等〕效度良好的神经心理学量表 ,评定了阿尔茨海默病(AD)轻异组 (3 0例 )和脑血管性痴呆 (VD)轻异组 (2 4例 )小檗碱干预前后的认知功能 ,并应用放射免疫 (RIA)法测定了血清肿瘤坏死因子 (TNF α)和酶联免疫吸附测定法 (ELISA)检测了全血细胞凋亡抑制基因 (Bcl 2 )的表达。 结果 服用小檗碱 1疗程后 ,AD和VD轻异组BSSD等量表评定成绩提高 ,与治疗前比较具有非常显著差异 (PAD<0 0 2、PVD<0 0 1) ,治疗前AD和VD轻异组血清TNFα和全血Bcl 2基因的表达均高于老年健康对照组 (P <0 0 1) ,经治疗后 ,血清TNF α含量下降和全血Bcl 2上调。 结论 提示小檗碱可改善痴呆高危人群认知功能 ,可能与血清TNFα水平下降和全血Bcl 2基因表达上调有关。

Objective To study the action mechanism and significance of berberin in preclinical dementia in the aged. Methods A group of neuropsychological rating scales,i.e.brief screening scale for dementia(BSSD),Benton visual retention test (VRT)and digit span(DS),with better reliability and validity were applied to evaluate the change of cognitive function in 30 cases of the preclinical Alzheimer’s disease(BSSD≥22～29 points called as PAD group)and 24 cases of the preclinical of vascular demential(BSSD≥22～29 points called as PVD group)before and after the administration of berberin.We used a number of rating scales above,simultaneously serum tumor necrosis factorα(TNFα)and whole blood B cell lymphoma/leukemia2(Bcl2)were measured by radioimmunoassay(RIA)and ELISA respectively. Results The cognitive function was greatly improved,with the score of BSSD and other tests in PAD and PVD significantly higher than those before the administration of berberin(P AD <0.02,P VD <0.01).The whole blood Bcl2 and the levels of TNFα in PAD and PVD were all significantly higher than those in healthy and elderly control group before administration.While after treatment Bcl2 genetic expression was upregulated and the level of serum TNFα was declined. Conclusions All these findings suggest that improving effect of berberin on cognitive function in high risking people of aged dementia may be related with whole blood Bcl2 gene’s higher expression and declining level of serum TNFα which may protect the neurocytes of chronic cerebropathy.