盐酸多奈哌齐联合美金刚对血管性认知障碍患者血清相关蛋白酶水平的影响

Effect of Donepezil Hydrochloride Tablets Combined with Memantine Hydrochloride Tablets on Levels of Serum-Associated Protease in Patients with Vascular Cognitive Impairment

目的探讨盐酸多奈哌齐联合美金刚治疗血管性认知障碍的临床疗效,及其对患者血清基质金属蛋白酶-9(MMP-9)和组织金属蛋白酶抑制剂-1(TIMP-1)水平的影响。方法将120例血管性认知障碍患者随机分为研究组和对照组,各60例。研究组患者给予盐酸多奈哌齐联合美金刚治疗,对照组患者单用盐酸多奈哌齐治疗。结果治疗后,研究组患者简易智能精神状态评估量表(MMSE)、长谷川痴呆量表(HDS)、痴呆严重程度临床评定量表(CDR)评分及大脑中动脉收缩期血流速率(V_s)明显高于对照组患者(P<0.05),日常生活功能量表(ADL)评分、平均血流速率(V_m)、脉动指数(PI)、MMP-9及TIMP-1水平明显低于对照组患者(P<0.05);两组患者血、尿常规,肝、肾功能检查均无明显变化,均未出现明显不良反应。结论盐酸多奈哌齐联合美金刚治疗血管性认知障碍,可明显改善临床症状,降低血清MMP-9及TIMP-1水平,疗效优于单用盐酸多奈哌齐,且不良反应少,值得临床推广。

Objective To investigate the clinical effect of Donepezil Hydrochloride Tablets combined with Memantine Hydrochloride Tablets for treating patients with vascular cognitive impairment and its effect on the levels of serum matrix metalloproteinase 9（MMP-9）and tissue inhibitor of metalloproteinase 1（TIMP-1）. Methods Totally 120 patients with vascular cognitive impairment were randomly divided into the study group and the control group,60 cases in each group. The study group was given Donepezil Hydrochloride Tablets combined with Memantine Hydrochloride Tablets,while the control group was given Donepezil Hydrochloride Tablets. Results After treatment,the scores of mini-mental state examination scale（MMSE）,Hasegawa＇s dementia scale（HDS） and clinical dementia rating（CDR） of dementia severity,and the mean velocity（Vs） of cerebral blood flow of middle cerebral artery in the study group were significantly higher than those in the control group（P〈0. 05）,while the activity of daily living（ADL） score,the mean velocity（Vm） of blood flow,pulsatility index（PI）,the levels of MMP-9 and TIMP-1 in the study group were significantly lower than those in the control group（P〈0. 05）. There was no obvious change in blood,urine routine test,liver and kidney function examination before and after treatment in the two groups,and no obvious adverse reaction was found. Conclusion Donepezil Hydrochloride Tablets combined with Memantine Hydrochloride Tablets for treating patients with vascular cognitive impairment can significantly improve the clinical symptoms and reduce the levels of serum MMP-9 and TIMP-1,which has better curative effect alone and fewer adverse reactions than Donepezil Hydrochloride Tablets,it is worthy of clinical promotion.