有氧运动联合叶酸治疗对阿尔茨海默病患者认知功能及血清细胞因子、Hcy的影响

Effect of aerobic exercise combined with folic acid on cognitive function,serum cytokines and Hcy in patients with Alzheimer′s disease

目的探讨有氧运动联合叶酸治疗对阿尔茨海默病(AD)患者认知功能及血清细胞因子、血清同型半胱氨酸(Hcy)的影响。方法选择2016年5月~2018年1月四川省南充市中心医院诊治的86例AD患者作为研究对象,依据随机数字表法分为对照组和观察组,每组各43例。对照组给予盐酸多奈哌齐治疗+有氧运动训练,观察组在对照组基础上联合叶酸治疗,疗程为3个月。采用简明精神状态量表(MMSE)、阿尔茨海默病评价量表-认知分表(ADAS-cog)评定患者的认知功能,比较两组治疗前后血清Hcy、白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)水平。结果治疗前两组MMSE评分、ADAS-cog评分比较,差异无统计学意义(P>0.05)。治疗后,两组MMSE评分高于治疗前,且观察组高于对照组;两组ADAS-cog评分低于治疗前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。治疗前两组血清细胞因子水平、血清Hcy水平比较,差异无统计学意义(P>0.05)。治疗后,两组血清IL-6、TNF-α、IL-1β水平低于治疗前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组血清Hcy水平低于治疗前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。结论叶酸联合有氧运动训练可更为有效地改善AD患者的认知功能,可能与下调血清Hcy水平、抑制促炎症细胞因子分泌有关。

Objective To implore the effect of aerobic exercise combined with folic acid on cognitive function,serum cytokines and homocysteine(Hcy)in patients with Alzheimer′s disease(AD).Methods From May 2016 to January 2018,86 cases with AD who treated in Nanchong City Central Hospital of Sichuan Province were selected.They were divided into control group and observation group according to the random number table method,with 43 cases in each group.Control group was treated with Donepezil Hydrochloride combine with aerobic exercise training,while observation group was treated with folic acid on the basis of control group.Both groups were treated for 3 months.Mini-mental state scale(MMSE)and the Alzheimer′s disease rating scale-cognitive sub-table(ADAS-cog)were used to evaluate the cognitive function of the patients.Serum levels of Hcy,interleukin-6(IL-6),IL-1βand tumor necrosis factor-α(TNF-α)before and after treatment were compared between two groups.Results There was no significant difference in MMSE scores and ADAS-cog scores between two groups before treatment(P>0.05).After treatment,MMSE scores in two groups were higher than those before treatment,and observation group were higher than control group.ADAS-cog scores of two groups were lower than those before treatment,and observation group was lower than control group,with statistically significant differences(all P<0.05).There was no significant difference in serum cytokine levels and serum Hcy levels between two groups before treatment(P>0.05).After treatment,serum levels of IL-6,TNF-αand IL-1βin two groups were lower than those before treatment,and observation group were lower than control group,with statistically significant differences(all P<0.05).The serum Hcy level in observation group was lower than that before treatment,and observation group was lower than control group,with statistically significant difference(all P<0.05).Conclusion Folic acid combined with aerobic exercise training can more effectively improve the cognitive function of AD patients,which may be related to the down-regulation of serum Hcy levels and the suppression of secretion of pro-inflammatory cytokines.