丁苯酞联合舍曲林对帕金森病合并抑郁症患者认知功能及血清NT-3、BDNF、5-HT水平的影响

Effects of butylphthalide combined with sertraline on cognitive function and serum levels of NT-3,BDNF,and 5-HT in patients with Parkinson’s disease complicated with depression

目的分析丁苯酞联合舍曲林对帕金森病合并抑郁症患者认知功能及血清神经营养因子-3(NT-3)、脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)水平的影响。方法158例帕金森病合并抑郁症患者均分为联合组(79例,丁苯酞联合舍曲林口服)和舍曲林组(79例,盐酸舍曲林口服),均治疗12周;于治疗前及治疗12周时,检测2组患者血清NT-3、BDNF及5-HT水平,采用帕金森病统一评分量表(UPDRS)、39项帕金森病调查表(PDQ-39)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评价治疗效果;于治疗前、治疗第4及12周时,采用简易智能状态检查量表(MMSE)评估两组患者的认知功能。结果治疗12周时,联合组患者总有效率(94.94%)高于舍曲林组(81.01%,P<0.05),UPDRS、PDQ-39、HAMD及HAMA评分低于治疗前,且联合组低于舍曲林组,差异有统计学意义(P<0.05);治疗前、治疗4、12周时,2组患者MMSE评分逐渐升高,且治疗4和12周时联合组高于舍曲林组,差异有统计学意义(P<0.05);2组患者治疗12周时的血清NT-3、BDNF、5-HT水平高于治疗前,联合组高于舍曲林组,差异有统计学意义(P<0.05)。结论丁苯酞联合舍曲林可改善帕金森病合并抑郁症患者帕金森、抑郁、焦虑症状及认知功能,其机制可能与联合治疗提高患者血清NT-3、BDNF、5-HT水平有关。

Objective To investigate the effects of butylphthalide combined with sertraline on cognitive function and serum levels of neurotrophic factor-3(NT-3),brain-derived neurotrophic factor(BDNF),and 5-hydroxytryptamine(5-HT)in patients with Parkinson’s disease complicated with depression.Methods One hundred and fifty-eight patients with Parkinson’s disease complicated with depression were divided into combined group(79 cases,oral taken butylphthalide combined with sertraline)and sertraline group(79 cases,oral taken sertraline),both were treated for 12 weeks.Detecting levels of NT-3,BDNF,and 5-HT after 12 weeks of treatment in both groups in order to evaluate curative effects by:unified Parkinson’s Disease Scale(UPDRS),39 Parkinson’s Disease Questionnaire(PDQ-39),Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA).Before treatment,on the 4thand 12thweek of treatment,MMSE was adopted to evaluate cognitive functions of both groups.Results In the 12thweek of treatment,the total effective rate of the combined group was 94.94%,which was higher than that of sertraline group(81.01%,P<0.05).The scores of UPDRS,PDQ-39,HAMD,and HAMA in both groups were lower than those before treatment,while those in the combined group were lower than those in the sertraline group,differences were statistically significant(P<0.05).Before treatment,in the 4thand 12thweeks of treatment,the scores of MMSE of both groups gradually increased,and the combined group was higher than that of sertraline group in the 4thand 12thweeks of treatment,differences were statistically significant(P<0.05).In the 12thweek of treatment,the serum levels of NT-3,BDNF,and 5-HT of both groups were higher than those before treatment,and those of combined group were higher than those of sertraline group,difference were statistically significant(P<0.05).Conclusion Butylphthalide combined with sertraline can improve symptoms of Parkinson’s disease,depression,anxiety,and cognitive function.Its mechanism may be related to improved serum levels of NT-3,BDNF,and 5-HT.