高压氧联合认知训练治疗血管性认知障碍的疗效及其对血浆中Klotho蛋白和同型半胱氨酸的影响

Hyperbaric oxygen therapy can augment the effectiveness of cognition training for persons with vascular cognitive impairment

目的观察高压氧联合认知训练对脑卒中后血管性认知障碍(VCI)患者的疗效,以及对VCI患者体内血浆Klotho蛋白和同型半胱氨酸(Hcy)水平的影响。方法采用随机数字表法将VCI患者42例分为对照组19例和研究组23例,对照组患者在基础治疗的基础上增加高压氧治疗(每日1次,连续治疗4周),研究组则在基础治疗的基础上增加高压氧联合认知训练(每周治疗5 d,连续治疗4周)治疗。2组患者均于治疗前和治疗4周后(治疗后)采用简易精神状况量表(MMSE)对2组患者的认知功能进行评估,并同时取2组患者早晨空腹静脉血液3 ml,采用酶联免疫吸附测定法(ELISA)检测其血浆Klotho蛋白和Hcy水平。结果治疗后,2组患者的MMSE评分较组内治疗前均显著改善,且研究组治疗后的MMSE评分为(16.96±6.01)分,显著优于对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,研究组的血浆Klotho蛋白和Hcy水平较组内治疗前均显著改善,且显著优于对照组治疗后,差异均有统计学意义(P<0.05);而对照组患者仅治疗后的血浆Hcy水平显著优于组内治疗前(P<0.05)。结论高压氧治疗联合认知训练可显著改善VCI患者的认知功能,起作用机制可能与其可改善血浆Klotho蛋白和Hcy水平有关。

Objective To explore the effect of combining hyperbaric oxygen(HBO)therapy with cognition training for persons with vascular cognitive impairment(VCI).Methods Forty-two persons with VCI were randomly divided into a control group of 19 and a research group of 23.In addition to basic treatment,the control group was given hyperbaric oxygen therapy once a day,5 days per week for 4 weeks,while the research group received cognition training along with the hyperbaric oxygen therapy.Each person′s cognition was assessed using the Simple Mental Status Scale(MMSE)before and after the four-week treatment.Meanwhile,3ml of venous blood was collected before eating in the morning to test the plasma levels of Klotho protein and homocysteine using enzyme-linked immunosorbent assays.Results After the treatment the average MMSE score had improved significantly in both group,with the improvement in the research group′s average significantly greater than that in the control group.The average plasma levels of Klotho protein and homocysteine had also improved significantly more in the research group.In the control group,the only significant improvement was in the average homocysteine level.Conclusions Hyperbaric oxygen therapy can be an effective supplement to cognition training for persons with vascular cognitive impairment.