经皮神经电刺激对阿尔茨海默病患者血流变指标的影响

The effects of transcutaneous electric nerve stimulation on hemorheology index in patients with Alzheimer

目的研究经皮神经电刺激对阿尔茨海默病患者血流变学指标的影响。方法选择2014年5月-2015年9月嘉兴市康慈医院住院的60例阿尔茨海默病患者为研究对象(AD组),随机抽取同期健康体检者60例为对照组(NC组),AD组采用经皮神经电刺激仪治疗12周,2组采用简易智能状态检测量表(MMSE)及日常生活能力量表(ADL)评分进行评定并同时测定血流变学相关指标。结果治疗后AD组中各指标有明显下降,其中全血黏度(高切、中切)、血浆黏度、高切还原黏度降低最明显,与对照组比较,差异无统计学意义(P>0.05);阿尔茨海默病患者血液中全血黏度(高切、中切、低切)、血浆黏度、还原黏度(高切、中切、低切)、红细胞聚集指数、血沉、血沉方程K值、红细胞电泳时间和纤维蛋白原与MMSE评分存在明显正相关(r值分别为0.324、0.340、0.228、0.248、0.331、0.401、0.451、0.255、0.266、0.278、0.298、0.354,P值均<0.05),而与ADL评分存在明显负相关(r值分别为-0.404、-0.240、-0.308、-0.334、-0.354、-0.382、-0.428、-0.334、-0.256、-0.268、-0.306、-0.345、-0.305、-0.225,P值均<0.05)。结论阿尔茨海默病患者存在明显血流变学指标异常,经皮神经电刺激仪治疗后患者的痴呆程度明显减轻,血液流变学相关指标得到改善,日常生活能力得到提高。

Objective To study the effects of transcutaneous electric nerve stimulation（ TENS） on hemorheology index in patients with Alzheimer disease. Methods 60 hospitalized AD patients and other 60 healthy subjects were enrolled in this study as the AD group and the NC group during May 2014- September 2015. AD group was given TENS therapy for 12 weeks,and both groups were evaluated for mini- mental state examination（ MMSE） and activity of daily living（ ADL） scores,so as to simultaneously examine the hemorrheological parameters before treatment and after treatment. Results After the treatment,each index in the AD group has decreased significantly,of which whole blood viscosity（ high shear,cut）,plasma viscosity,high shear reduced viscosity decreased most obvious,and compared to the control group,the difference was not statistically significant（ P 〉 0. 05）. The score of MMSE had a positive correlation with whole blood viscosity（ low,middle and high shear rate）,plasma viscosity,whole blood deoxidize viscosity（ low,middle and high shear rate）,RBC aggregation,ESR,the K value of the blood sedimentation equation,erythrocyte electrophoresis and fibrinogen in the patients with Alzheimer（ r = 0. 324,0. 340,0. 228,0. 248,0. 331,0. 401,0. 451,0. 255,0. 266,0. 278,0. 298,0. 354,P 〈 0. 05）,but the score of ADL had a negative correlation with that（ r =- 0. 404,- 0. 240,- 0. 308,- 0. 334,- 0. 354,- 0. 382,- 0. 428,- 0. 334,- 0. 256,- 0. 268,- 0. 306,- 0. 345,- 0. 305,- 0. 225,P 〈 0. 05）. Conclusion There was obvious abnormal hemorheology index in patients with Alzheimer,and TENS can ameliorate dysnoesia in patients with Alzheimer,improve AD hemorheology indexes and enhance the activity of daily living.