曲可芦丁联合胞磷胆碱对脑梗死患者认知功能的改善作用及机制

Improvement Effect and Mechanism of Troxerutin Combined with Citicoline on Cognitive Function in Patients with Cerebral Infarction

为了探讨曲克芦丁联合胞磷胆碱对脑梗死的治疗效果及机制,本研究将100例急性脑梗死患者分为对照组和观察组(n=50),对照组患者采用常规治疗,观察组在对照组治疗基础上加用曲克芦丁和胞磷胆碱。采用简易精神状态检查表(MMSE)对脑梗死患者的认知功能进行评价。将60只SD大鼠随机分为3组(n=20):假手术组、模型组和曲克芦丁+胞磷胆碱组。通过Morris水迷宫实验评价大鼠的认知功能。TTC染色评价大鼠脑梗死体积。Nissl染色评价大鼠海马区的组织形态。TUNEL染色评价大鼠海马细胞凋亡。Western blotting检查海马组织中TGF-β2、VEGF-A和CD34的蛋白表达。研究显示,治疗后观察组的MMSE总评分显著高于对照组(p<0.05)。与模型组比较,曲克芦丁+胞磷胆碱组大鼠的逃避潜伏期显著降低,而穿越平台次数显著升高(p<0.05)。与模型组相比,曲克芦丁+胞磷胆碱组大鼠的梗塞体积明显减少(p<0.05)。与模型组相比,曲克芦丁+胞磷胆碱组的海马CA1区细胞凋亡率显著降低(p<0.05)。与模型组相比,曲克芦丁+胞磷胆碱组的TGF-β2、VEGF-A和CD34的表达水平显著上调(p<0.05)。本研究表明,曲克芦丁联合胞磷胆碱可有效改善脑梗死患者和动物模型的认知功能。2种药物组合的脑保护作用可能与减弱脑组织损伤、抑制神经元凋亡、促进血管生成有关。

To explore the effect and mechanism of troxerutin combined with citicoline on cerebral infarction, one hundred patients with acute cerebral infarction were divided into the control group and the observation group(n=50).The patients in the control group were treated conventionally. The observation group was treated with troxerutin and citicoline on the basis of the control group. Cognitive function of patients with cerebral infarction was evaluated by using Mini-mental State Examination(MMSE). Sixty SD rats were randomly divided into three groups(n =20): a sham group, a model group, and a troxerutin +citicoline group. The cognitive function of rats was evaluated by Morris water maze experiment. TTC staining was used to evaluate the volume of cerebral infarction in rats. Nissl staining was used to evaluate the morphology of rat hippocampus. TUNEL staining was used to evaluate rat hippocampal apoptosis. Western blotting was used to examine the expression of TGF-β2, VEGF-A and CD34 in hippocampus. Studies showed that the total score of MMSE in the observation group was significantly higher than that of the control group after treatment(p<0.05). Compared with the model group, the escape latency of rats in the troxerutin +citicoline group was significantly reduced, while the number of crossing platforms was significantly increased(p<0.05). Compared with the model group, the infarct volume of rats in the troxerutin+citicoline group was significantly reduced(p<0.05). Compared with the model group, the apoptosis rate in the hippocampal CA1 region of the troxerutin+citicoline group was significantly reduced(p<0.05). Compared with the model group,the expression levels of TGF-β2, VEGF-A and CD34 in the troxerutin +citicoline group were significantly increased(p<0.05). This study indicated that troxerutin combined with citicoline could effectively improve cognitive function in patients with cerebral infarction and animal models. The protective effects of the two drugs in combination may be related to weakening brain tissue damage, inhibiting neuronal apoptosis, and promoting angiogenesis.