鼠神经生长因子联合多奈哌齐对老年痴呆患者炎症因子和认知功能的影响

Effects of mouse nerve growth factor combined with donepezil on inflammatory factors and cognitive function of patients with senile dementia

目的 探讨鼠神经生长因子(m NGF)联合多奈哌齐对老年痴呆(AD)患者炎症因子和认知功能的影响。方法 92例AD患者均分为对照组和观察组,对照组给予多奈哌齐治疗,观察组给予m NGF联合多奈哌齐治疗,两组患者均治疗8;于治疗前及治疗8周时,采用酶联免疫法测定2组患者的血清白细胞介素-1β(IL-1β)、IL-6及C反应蛋白(CRP)水平,采用阿尔茨海默病评定量表认知分量表(ADAS-cog)和临床痴呆评定量表(CDR)评估2组患者的认知功能及痴呆程度,比较2组患者的治疗效果及不良反应发生率。结果 治疗前,两组患者血清IL-1β、IL-6、CRP水平及ADAS-cog、CDR评分比较,差异无统计学意义(P> 0.05);治疗8周时,2组患者血清IL-1β、IL-6、CRP水平及ADAS-cog、CDR评分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P <0.05);观察组的治疗有效率高于对照组,差异有统计学意义(P <0.05);两组患者的不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 m NGF联合多奈哌齐对老年痴呆患者认知功能的疗效优于单一多奈哌齐治疗,其机制可能与联合治疗改变血清炎症细胞因子水平有关。

Objective To investigate the effect of mouse nerve growth factor(mNGF)combined with donepezil on inflammatory factors and cognitive function of patients with Alzheimer's disease(AD).Methods A total of 92 patients with AD were randomly divided into control and observation groups.Observation group was treated with mNGF plus donepezil,while control group was given donepezil alone.The treatment lasted for 8 weeks.Before and at 8 weeks of the treatment,enzyme-linked immunosorbent assay(ELISA)was applied to detect serum interleukin-1β(IL-1β),IL-6,and C-reactive protein(CRP).The cognitive function and dementia degree of two groups were evaluated using AD Assessment Scale Cognitive(ADAS-cog)and Clinical Dementia Rating(CDR)Scale.Therapeutic efficacy and adverse reaction rate were compared between two groups.Results Before treatment,there were no significant differences in the levels of serum IL-1β,IL-6,and CRP between two groups(P>0.05).At 8 weeks of treatment,the levels of serum IL-1β,IL-6,and CRP,ADAS-cog,and CDR scores in two groups were lower than those before treatment,and they were lower in observation group than those in control group(P<0.05).Therapeutic efficacy rate was greater in observation group than that in control group(P<0.05).There was no statistically significant difference in adverse reaction rate between two groups(P>0.05).Conclusion The therapeutic effect of mNGF plus donepezil on cognitive function of AD patients is superior to donepezil alone.Its mechanism may be related to the change of serum inflammatory cytokine levels after combined treatment.