基于脑血流动力学、炎性因子探究银杏叶注射液联合多奈哌齐治疗阿尔茨海默病的临床疗效

The Clinical Efficacy of Ginkgo Leaf Injection Combined with Donepezil in the Treatment of Alzheimer's Disease Based on Cerebral Hemodynamics and Inflammatory Factors

目的基于脑血流动力学、炎性因子探究银杏叶注射液与多奈哌齐联合治疗阿尔茨海默病(AD)的疗效。方法选取2020年3月至2022年1月张家口市沙岭子医院90例AD患者,随机分为对照组(45例)、研究组(45例)。2组均行常规对症治疗,于此基础上,对照组给予多奈哌齐治疗,研究组给予银杏叶注射液联合多奈哌齐治疗。比较2组治疗效果、脑血流动力学指标[双侧大脑中动脉(双侧MCA)、基底动脉(BA)平均血流速度(MFV)和搏动指数(PI)]、炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、IL-1β]、s100β蛋白、Aβ-淀粉样蛋白1-42(Aβ1-42)、缓激肽(BK)、认知功能、日常生活能力、不良反应。结果与对照组(77.78%)比较,研究组总有效率(93.33%)明显提高(P<0.05);治疗后1、3、6个月,研究组BA、双侧MCA的MFV高于对照组,BA、双侧MCA的PI低于对照组(P<0.05);研究组治疗后1、3、6个月血清TNF-α、IL-6、IL-1β水平低于对照组(P<0.05);治疗后1、3、6个月,研究组血清s100β蛋白、Aβ1-42、BK水平低于对照组(P<0.05);研究组治疗后1、3、6个月简易精神状态检查量表(MMSE)评分高于对照组,AD评估分量表认知量表(ADAS-cog)、日常生活能力量表(ADL)评分低于对照组(P<0.05);研究组不良反应发生率(13.33%)与对照组(8.89%)比较,差异无统计学意义(P>0.05)。结论银杏叶注射液辅以多奈哌齐治疗AD的疗效显著,可能是通过改善脑血流动力学、下调炎性因子及血清s100β蛋白、Aβ1-42、BK水平的途径实现。

Objective To explore the efficacy of combination therapy of Ginkgo biloba injection and donepezil in the treatment of Alzheimer's disease(AD)based on cerebral hemodynamics and inflammatory factors.Methods A total of 90 patients with AD in Zhangjiakou Shalingzi Hospital from March 2020 to January 2022 were randomly divided into a control group(45 cases)and a study group(45 cases).Both groups received the conventional symptomatic treatment.On this basis,the control group was given donepezil treatment,and the study group was given ginkgo leaf injection combined with donepezil treatment.The therapeutic effects,cerebral hemodynamic parameters[mean flow velocity(MFV)and pulsatility index(PI)of bilateral middle cerebral arteries(bilateral MCA)and basilar arteries(BA)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β],s100βprotein,Aβ-amyloid 1-42(Aβ1-42),bradykinin(BK),cognitive function,activities of daily living,and adverse reactions were compared between the two groups.Results Compared with the control group(77.78%),the total effective rate of the study group(93.33%)was significantly improved(P<0.05);1,3,and 6 months after the treatment,the MFV of BA and bilateral MCA in the study group was higher than that in the control group,while the PI of BA and bilateral MCA was lower than that in the control group(P<0.05);The levels of serum TNF-α,IL-6,and IL-1βin the study group were lower than those in the control group 1,3,and 6 months after the treatment(P<0.05);1,3,and 6 months after the treatment,the levels of serum s100βprotein,Aβ1-42,and BK in the study group were lower than those in the control group(P<0.05);1,3,and 6 months after the treatment,the score of the mini-mental state examination scale(MMSE)in the study group was higher than that in the control group,while the scores of the AD assessment subscale cognitive scale(ADAS-cog)and activities of daily living scale(ADL)were lower than those in the control group(P<0.05);The incidence of adverse reactions in the study group(13.33%)was not significantly different from that in the control group(8.89%)(P>0.05).Conclusion The efficacy of ginkgo biloba injection combined with donepezil in the treatment of AD is significant,which may be achieved by improving cerebral hemodynamics,downregulating inflammatory factors,and regulating the levels of serum s100βprotein,Aβ1-42,and BK.