尼莫地平联合丁苯酞对帕金森合并认知功能障碍患者血清相关因子的影响

Effect of Nimodipine Combined with Butylphthalide on Serum Related Factors in Patients with Parkinson's Cognitive Impairment

目的探讨丁苯酞软胶囊联合尼莫地平对帕金森合并认知功能障碍患者MMSE评分及血清BDNF、IGF-1水平变化的影响。方法选取2013年11月~2016年10月本院96例帕金森合并认知功能障碍患者,根据治疗方案分为尼莫地平组、丁苯酞组、联合组,各32例,另选取同期于本院进行健康体检者32例设为健康组。常规治疗基础上,尼莫地平组采用尼莫地平,丁苯酞组采用丁苯酞软胶囊,联合组采用尼莫地平+丁苯酞软胶囊,三组均持续治疗3个月。入院时及疗程结束后统计对比三组认知功能评分(MMSE)、日常生活能力分值(ADL)以及治疗前后尼莫地平组、丁苯酞组、联合组与健康组血清脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)水平、三组不良反应发生率。结果治疗后尼莫地平组、丁苯酞组、联合组MMSE评分较治疗前增高,组间比较差异有统计学意义(P<0.05),且联合组MMSE评分较尼莫地平组、丁苯酞组高,差异有统计学意义(P<0.05);治疗后尼莫地平组、丁苯酞组、联合组ADL分值较治疗前增高,组间比较差异有统计学意义(P<0.05),且联合组ADL分值较尼莫地平组、丁苯酞组高,差异有统计学意义(P<0.05);治疗前联合组、尼莫地平组、丁苯酞组血清BDNF、IGF-1水平与健康组比较,差异有统计学意义(P<0.05),治疗后联合组、尼莫地平组、丁苯酞组血清BDNF、IGF-1水平与健康组比较,差异有统计学意义(P<0.05),但联合组血清BDNF、IGF-1水平较尼莫地平组、丁苯酞组高,差异有统计学意义(P<0.05);三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用丁苯酞软胶囊联合尼莫地平治疗帕金森合并认知功能障碍,可有效提高血清BDNF、IGF-1水平,改善患者认知功能及日常生活能力,且不会增加不良反应发生风险,具有安全性。

Objective To investigate the effect of nifedipine combined with nimodipine on MMSE score and serum BDNF and IGF-1 levels in patients with cognitive dysfunction. Methods From November 2013-October 2016, 96 patients with Parkinson ‘s disease with cognitive dysfunction in our hospital were divided into nimodipine group, butylphthalide group and combined group according to treatment plan, 32 cases each group, and 32 cases of physical examination healthy subjects at the same time in our hospital were set as healthy group. On the basis of conventional therapy, nimodipine group was treated with nimodipine and butylphthalide group. The combination group was treated with nimodipine and butylphthalide soft capsules. Both of the three groups were treated for 3 months. Cognitive function score（MMSE）, daily living ability score（ADL） of the three groups were compared at the time of admission and after treatment, besides, before and after treatment the levels of serum brainderived neurotrophic factor（BDNF）, insulin-like growth factor-1（IGF-1）, serum levels of insulin-like growth factor-1（IGF-1） in the nimodipine group, butylphthalide group, combined group and healthy group, and the incidence of adverse reactions in the three groups were analyzed as well. Results After treatment, the MMSE scores of nimodipine group, butylphthalide group and combination group were higher than those before treatment, the difference was statistically significant（P〈0.05）, and the MMSE score of the combined group was higher than that of the nimodipine group and the butylphthalide group（P〈0.05）; After treatment, the scores of ADL in nimodipine group, butylphthalide group and combined group were higher than those before treatment, the difference was statistically significant（P〈0.05）, And the ADL score of the combined group was higher than the nimodipine group, butadiene phthalide group high, the difference was statistically significant（P〈0.05）; After treatment, the levels of serum BDNF and IGF-1 in the combined group, nimodipine group and butylphthalide group were significantly higher than those in the healthy group（P〈0.05）, however, the levels of serum BDNF and IGF-1 in the combined group were significantly higher than those in the nimodipine group and the butylphthalide group（P〈0.05）; There was no significant difference in the incidence of adverse reactions between the three groups（P〈0.05）. Conclusion The combination of nifedipine and nimodipine in the treatment of Parkinson＇s cognitive impairment can improve the level of serum BDNF and IGF-1, improve patients＇ cognitive function and daily living ability, and will not increase the risk of adverse reactions, its safety is high.