高压氧联合多奈哌齐和盐酸美金刚治疗血管性认知障碍的效果观察

Efficacy of hyperbaric oxygen combined with donepezil and memantine hydrochloride on vascular cognitive impairment

目的分析高压氧联合多奈哌齐、盐酸美金刚治疗血管性认知障碍的临床效果。方法抽取2018年1月至2021年1月安阳市人民医院收治的血管性认知障碍患者80例,按随机数字表法分为观察组与对照组,每组40例。对照组采用多奈哌齐、盐酸美金刚治疗,观察组在对照组治疗基础上给予高压氧治疗,对比两组疗效和治疗前后临床痴呆量表(CDR)、蒙特利尔认知评估量表(MOCA)评分、事件相关电位P300(P300波幅、P300潜伏期)、血清细胞因子水平[低氧诱导因子-1α(HIF-1α)、血管形成素-1(Ang-1)、脑源性神经营养因子(BDNF)]。结果观察组总有效率为95.00%(38/40),高于对照组的77.50%(31/40),P<0.05。治疗后,两组CDR评分均较治疗前降低,MOCA评分均较治疗前增高,且观察组CDR评分低于对照组,MOCA评分高于对照组(P<0.05)。治疗后,两组P300波幅均较治疗前增高,P300潜伏期均较治疗前缩短,且观察组P300波幅高于对照组,P300潜伏期短于对照组(P<0.05)。治疗后,两组血清HIF-1α均较治疗前降低,Ang-1、BDNF均较治疗前增高,且观察组HIF-1α低于对照组,Ang-1、BDNF高于对照组(P<0.05)。结论高压氧联合多奈哌齐、盐酸美金刚治疗血管性认知障碍效果显著,可改善事件相关电位P300波幅、潜伏期,调节血清细胞因子表达,减轻认知损害,提高认知功能。

Objective To analyze the clinical effect of hyperbaric oxygen combined with donepezil and memantine hydrochloride in the treatment of vascular cognitive impairment.Methods A total of 80 patients with vascular cognitive impairment treated in Anyang People’s Hospital from January 2018 to January 2021 were selected and divided into observation group and control group by random number table method,with 40 cases in each group.The control group was treated with donepezil and memantine hydrochloride,while the observation group was treated by hyperbaric oxygen based on the treatment of the control group.The clinical dementia scale(CDR),Montreal cognitive assessment scale(MOCA)scores,event-related potential P300(P300 amplitude,P300 latency),serum cytokine levels,such as hypoxia inducible factor-1α(HIF-1α),angiokin-1(ANG-1),brain-derived neurotrophic factor(BDNF)before and after treatment were compared between the two groups.Results The total effective rate of observation group was 95.00%(38/40),higher than the 77.50%(31/40)of control group(P<0.05).After treatment,CDR score of both groups was lower than that before treatment,while MOCA score of both groups was higher than that before treatment(P<0.05).CDR score of observation group was lower than that of control group,while MOCA score of observation group was higher than that of control group(P<0.05).After treatment,P300 amplitude and P300 latency in both groups were higher than those before treatment,and P300 amplitude in observation group was higher than that in control group,and P300 latency in observation group was shorter than that in control group(P<0.05).After treatment,serum HIF-1αdecreased,Ang-1 and BDNF increased in both groups,and HIF-1αin observation group was lower than that in control group,Ang-1 and BDNF were higher than those in control group(P<0.05).Conclusions Hyperbaric oxygen combined with donepezil and memantine hydrochloride has a significant effect in the treatment of vascular cognitive impairment.It can improve the amplitude and latency of event-related potential P300,regulate the expression of serum cytokines,reduce cognitive impairment,and improve cognitive function.