丁苯酞联合脑蛋白水解物治疗老年帕金森病患者的临床疗效及其对免疫功能、神经功能和认知功能的影响

Clinical effect of butylphthalide combined with brain protein hydrolysate in the treatment of elderly patients with Parkinson's disease and its effects on immune function,neurological function and cognitive function

目的探讨丁苯酞联合脑蛋白水解物治疗对老年帕金森病(PD)患者免疫功能、神经功能和认知功能的影响。方法将2019年4月至2021年4月期间北方学院附属第一医院收治的120例老年PD患者纳入本次前瞻性研究,采用区组随机法分为对照组(n=60)和研究组(n=60)。对照组患者治疗方案为常规治疗+丁苯酞,研究组治疗方案为常规治疗+丁苯酞+脑蛋白水解物。比较两组两组的临床疗效,治疗前后免疫功能指标、神经功能指标和认知功能评分。结果研究组的总有效率为93.33%,高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗后,研究组的统一帕金森评分量表(UPDRS)总评分为(17.15±2.50)分,低于对照组[(26.84±2.85)分],而研究组的MoCA评分为(29.04±4.33)分,高于对照组[(25.96±4.24)分],差异均有统计学意义(P<0.05)。研究组的CD4^(+)CD45RA+为(24.30±2.85)%,低于对照组[(27.05±2.92)%],但研究组的CD4^(+)CD45RO+、CD4^(+)CD25^(+)highFOXP3^(+)分别为(58.55±6.12)%和(1.72±0.24)%,高于对照组[(55.98±6.01)%和(1.40±0.21)%],差异均有统计学意义(P<0.05)。研究组的S-100β和神经元特异性烯醇化酶(NSE)分别为(70.33±7.75)ng/L、(13.12±1.53)ng/L,均低于对照组[(76.47±7.90)ng/L、(16.04±1.67)ng/L],研究组的脑源性神经营养因子(BNDF)为(21.68±0.69)μg/L,高于对照组[(17.39±0.61)μg/L],差异均有统计学意义(P<0.05)。结论丁苯酞联合脑蛋白水解物治疗老年PD患者疗效确切,可有效提高老年PD患者的免疫功能、神经功能和认知功能。

Objective To explore the effect of butylphthalide combined with brain protein hydrolysate on immune function,neurological function and cognitive function in elderly patients with Parkinson's disease(PD).Methods A toltal of 120 elderly patients with PD treated in the First Affiliated Hospital of Hebei North University from April 2019 to April 2021 were enrolled in this prospective study.The patients were randomly divided into control group(n=60)and study group(n=60).The treatment scheme of patients in the control group was routine treatment+butylphthalide,while that in the study group was routine treatment+butylphthalide+brain protein hydrolysate.The clinical efficacy,immune function index,neurological function index and cognitive function score before and after treatment were compared between the two groups.Results The total effective rate of the study group was 93.33%,which was higher than that of the control group(80.00%),the difference was statistically significant(P<0.05).After treatment,the total scores of the unified Parkinson's scale(UPDRS)in the study group were(17.15±2.50)pionts,which were much lower than those in the control group[(26.84±2.85)pionts],the MoCA scores of the study group were(29.04±4.33)pionts,which were higher than those in the control group[(25.96±4.24)points],the differences were statistically significant(P<0.05).The CD4^(+)CD45RA+of the study group was(24.30±2.85)%,which was lower than that of the control group[(27.05±2.92)%],but the CD4^(+)CD45RO+and CD4^(+)CD25^(+)highFOXP3^(+)of the study group were(58.55±6.12)%and(1.72±0.24)%,respectively,which were higher than those of the control group(55.98±6.01)%and(1.40±0.21)%,respectively,the differences were statistically significant(P<0.05).The levels of S-100βand neuron specific enolase(NSE)in the study group were(70.33±7.75)ng/L and(13.12±1.53)ng/L,respectively,which were lower than those in the control group[(76.47±7.90)ng/L and(16.04±1.67)ng/L],respectively,but the brain-derived neurotrophic factor(BNDF)in the study group was(21.68±0.69)μg/L,which was higher than that in the control group[(17.39±0.61)μg/L],the differences were statistically significant(P<0.05).Conclusion Butylphthalide combined with brain protein hydrolysate is effective in the treatment of elderly patients with PD,which can effectively improve the immune function,neurological function and cognitive function of elderly patients with PD.