尼莫地平联合多奈哌齐对血管性认知障碍患者氧化应激及血液流变学的影响

Effect of nimodipine combined with donepezil on oxidative stress and hemorheology in patients with vascular cognitive impairment

目的观察尼莫地平联合多奈哌齐对血管性认知障碍(VCI)患者氧化应激及血液流变学的影响,为改善VCI患者日常生活能力提供依据。方法选取2016年7月—2017年6月收治的VCI患者96例,按随机数表法分为对照组和观察组,各48例。对照组采用多奈哌齐治疗,观察组在对照组基础上加尼莫地平治疗。观察两组治疗前后氧化应激反应、血液流变学变化情况。计量资料比较采用t检验,P<0.05为差异有统计学意义。结果治疗前,两组超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、纤维蛋白原(FIB)、红细胞压积(PCV)、全血低切粘度(LBV)、全血高切粘度(HBV)等水平对比,差异无统计学意义(均P>0.05);治疗后,观察组MDA、FIB、PCV、LBV、HBV水平[(4.11±0.31)μmol/L、(2.12±0.27)g/L、(36.02±2.34)%、(16.24±0.79)m Pa·s、(4.29±0.11)m Pa·s]低于对照组[(5.86±0.52)μmol/L、(2.97±0.32)g/L、(42.17±3.80)%、(19.87±0.98)m Pa·s、(4.91±0.12)m Pa·s],SOD、CAT、GSH-Px水平[(87.65±9.41)μU/L、(26.10±2.94)U/L、(114.04±15.52)U/L]高于对照组[(75.43±7.12)μU/L、(19.87±2.41)U/L、(98.72±13.64)U/L],差异有统计学意义(均P<0.05)。结论尼莫地平与多奈哌齐联合治疗有助于改善VCI患者血液流变学,缓解体内氧化应激反应,促进病情转归,提升患者认知功能,安全性良好。

Objective To observe the effect of nimodipine combined with donepezil on oxidative stress and hemorheology in patients with vascular cognitive impairment（VCI）,and to provide evidence for improving VCI patients＇ daily living ability.Methods A total of 96 patients with VCI were selected from July 2016 to June 2017.They were divided into control group and observation group randomly（48 cases in each group）.Control group was given donepezil,while observation group was treated with nimodipine based on control group.The changes of oxidative stress response and hemorheology were observed in two groups before and after treatment.Measurement data were compared by t test.P〈0.05 was considered statistically significant.Results Before treatment,the levels of superoxide dismutase（SOD）,catalase（CAT）,malonaldehyde（MDA）,glutathione peroxidase（GSH-Px）,fibrinogen（FIB）,packed cell volume（PCV）,low-shear-rate blood viscosity（LBV）,high-shear-rate blood viscosity（HBV） between the two groups had no statistical difference（all P〉0.05）.After treatment,the MDA,FIB,PCV,LBV,HBV level[（4.11±0.31）μmol/L,（2.12±0.27）g/L,（36.02±2.34）%,（16.24±0.79）m Pa·s,（4.29±0.11）m Pa·s] in observation group were lower than control group[（5.86±0.52）μmol/L,（2.97±0.32）g/L,（42.17±3.80）%,（19.87±0.98）m Pa·s,（4.91±0.12）m Pa·s],while the SOD, CAT, GSH-Px level [（87.65±9.41）μU/L,（26.10±2.94）U/L,（114.04±15.52）U/L] were higher than control group [（75.43±7.12）μU/L,（19.87±2.41）U/L,（98.72±13.64）U/L]（all P〈0.05）.Conclusion Nimodipine combined with donepezil can improve hemorheology in VIC patients, alleviate the oxidative stress, promote the prognosis of patients, and improve the cognitive function of patients.