高压氧联合盐酸美金刚治疗老年痴呆症患者的临床疗效

Effects of hyperbaric oxygen combined with memantine hydrochloride in the treatment of Alzheimer's disease

目的探讨高压氧(HBO)联合盐酸美金刚治疗老年痴呆症患者的临床效果及对血清超氧化物歧化酶(SOD)及神经元特异性烯醇化酶(NSE)的影响。方法选取2015年6月至2018年6月陆军军医大学大坪医院老年科收治的88例老年痴呆症患者为研究对象,按患者的治疗方式分为联合组和对照组。其中对照组采用盐酸美金刚治疗,联合组采用HBO联合盐酸美金刚治疗。治疗8周后,比较2组患者的临床疗效,并分别采用简易精神状态检查量表(MMSE)和蒙特利尔认知量表(MoCA)评估患者的认知状态,比较患者的血清SOD和NSE水平变化情况,并分析2组患者出现的不良反应。结果治疗4个疗程后,联合组总有效率(84.09%)明显高于对照组(63.64%)(χ2=4.768,P=0.029);联合组患者的MMSE评分和MoCA评分均明显高于对照组[(21.42±1.15)vs(18.37±1.05)分;(25.46±1.39)vs(22.31±1.22)分],差异均有统计学意义(均P<0.05)。治疗后2组患者血清SOD水平升高,血清NSE水平降低,差异均有统计学意义(均P<0.05)。2组的不良反应率比较差异无统计学意义(χ2=0.067,P=0.769)。结论HBO联合盐酸美金刚治疗老年痴呆症患者具有较好的临床疗效,能够显著改善患者的认知功能,并升高血清SOD水平,降低NSE水平,减少氧化应激性损伤。

Objective To explore the effects of hyperbaric oxygen (HBO) combined with memantine hydrochloride in the treatment of Alzheimer's disease and its impact on the levels of serum SOD and NSE. Methods Eighty-eight patients with Alzheimer's disease admitted to our hospital from June 2015 to June 2018 were selected as the study subjects. The patients were divided into the combined group and the control group, in accordance with different treatment methods. The control group was treated with memantine hydrochloride, while the combined group was treated with HBO coupled with memantine hydrochloride. After 8 weeks of treatment, the clinical effects were compared between the patients of the 2 groups. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to assess the cognitive status of the patients. The changes of serum SOD and NSE levels were compared and adverse reactions of the 2 groups were analyzed for the patients of the 2 groups. Results The total effective rate of the combined group (84.09%) was obviously higher than that of the control group (63.64%)(χ2 = 4.768, P=0.029). After treatment, the scores of MMSE and MoCA in the combined group were (21.42 ±1.15) and (25.46±1.39) respectively, while those in the control group were (18.37 ±1.05) and (22.31±1.22) respectively (all P<0.05). Following treatment, the serum SOD levels of the 2 groups all increased, and the serum NSE level decreased (P<0.05). No significant significance could be noticed in the rate of adverse reactions, when comparisons were made between the 2 groups (χ2=0.067, P=0.769). Conclusion HBO combined with memantine hydrochloride in the treatment of Alzheimer's disease has good clinical efficacy, and could significantly improve the cognitive function of the patients, and increase serum SOD level, reduce NSE level and alleviate oxidative stress injury in the patients.