卡巴拉汀联合左旋多巴治疗中晚期帕金森病的认知功能障碍及对血清EGF及Aβ1-42的影响

Effects of rivastigmine combined with levodopa on cognitive dysfunction and serum EGF and serum Aβ1-42 in advanced Parkinson’s disease

目的探讨卡巴拉汀联合左旋多巴治疗中晚期帕金森病的认知功能障碍以及对血清表皮生长因子(EGF)和淀粉样蛋白(Aβ1-42)的影响。方法选取2017-01—2019-07郑州市第二人民医院收治的中晚期帕金森患者140例,将其随机分为对照组和观察组,每组70例。对照组给予左旋多巴治疗,观察组采用卡巴拉汀联合左旋多巴,所有患者均干预3个月。采用MoCA量表、MMSE量表评价认知功能,采用UPDRS量表评估病情,采用CSI量表评估肌张力,并检测患者DAT活性、血清EGF水平与Aβ1-42水平以及药物的不良反应。结果干预前,2组患者MoCA评分、MMSE评分、UPDRS评分、CSI评分、DAT活性、血清EGF水平以及Aβ1-42水平差异无统计学意义(P>0.05);干预后,2组患者的UPDRS评分、CSI评分、血清EGF水平较治疗前均有所下降(P<0.05),观察组下降幅度更加明显(P<0.05);干预后2组MoCA评分、MMSE评分、血清Aβ1-42水平较治疗前均有所增高(P<0.05),观察组患者增高更加明显(P<0.05);干预后2组DAT活性均有所降低(P<0.05),观察组降低幅度小于对照组;2组患者不良反应发生率相比差异无统计学意义(P>0.05)。结论卡巴拉汀联合左旋多巴治疗中晚期帕金森具有良好的治疗效果,安全性高。

Objective To investigate the effects of rivastigmine combined with levodopa on cognitive impairment and serum EGF and serum Aβ1-42 in patients with advanced Parkinson’s disease.Methods A total of 140 patients with advanced Parkinson’s disease who were treated in our hospital from January 2017 to July 2019 were selected.The patients were randomly divided into control group and observation group,each containing 70 patients.Patients in the control group were treated with levodopa,while patients in the observation group were treated with rivastigmine combined with levodopa.All patients received three months of treatment.We used MoCA scale and MMSE scale to evaluate patients’cognitive function,UPDRS scale to evaluate patients’condition,and CSI scale to evaluate patients’muscular tone.At the same time,we also measured the patients’DAT activity and serum EGF level and Aβ1-42 level.Finally,we observed the adverse reactions of the patients to the drugs.Results Before treatment,there were no statistically significant differences in MoCA score,MMSE score,UPDRS score,CSI score,DAT activity,serum EGF level and serum Aβ1-42 between the control group and the observation group(P>0.05).After treatment,the UPDRS score,CSI score and serum EGF level of patients in the two groups were lower than before(P<0.05),but the decrease was greater in the observation group(P<0.05).After treatment,MoCA score,MMSE score and serum Aβ1-42 level of patients in the two groups were increased compared with those before(P<0.05),but the increase was greater in the observation group(P<0.05).After three months of treatment,the DAT activity of the two groups decreased(P<0.05),but the decrease was smaller in the observation group than in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Rivastigmine combined with levodopa has a good therapeutic effect on patients with advanced Parkinson’s disease,which can improve the cognitive function of patients with high safety and is worthy of clinical application.