丁苯酞联合尼麦角林对血管性痴呆患者神经递质血液流变学及神经功能的改善作用

The Improvement of Neurotransmitter,Hemorheology and Neurological Function in Patients with Vascular Dementia by the Combination of Butylphthalide and Nimergoline

目的探讨在基础治疗上,加用丁苯酞和尼麦角林对血管性痴呆(vascular dementia,VaD)患者神经递质、血液流变学和神经功能的改善作用。方法选择沈阳医学院第二附属医院2022年1—12月收治的VaD患者50例,随机分为单药组和联合组各25例。两组均接受基础治疗,单药组采用尼麦角林单药改善循环;而联合组采用丁苯酞和尼麦角林双药改善循环,治疗3个月后比较两组患者的治疗效果。结果治疗后,联合组神经递质指标乙酰胆碱、去甲肾上腺素、多巴胺、5-羟色胺和脑源性神经营养因子水平高于单药组,差异有统计学意义(P<0.05);血液流变学指标血浆黏度、全血低切黏度、全血中切黏度、全血高切黏度和红细胞压积水平均低于单药组,差异有统计学意义(P<0.05);蒙特利尔认知评估量表和简易智力状态检查量表评分高于单药组,差异有统计学意义(P<0.05)。结论丁苯酞联合尼麦角林应用治疗VaD,能够进一步提升脑组织兴奋性和抑制性神经递质分泌水平,降低血液黏度和提高神经功能。

Objective To explore the improvement of neurotransmitters,hemorheology,and neurological function in patients with vascular dementia(VaD)by adding butylphthalide and nimergoline on basic treatment.Methods Fifty VaD patients admitted to the Second Affiliated Hospital of Shenyang Medical College from January to December 2022 were randomly divided into a monotherapy group and a combination group,with 25 cases in each group.Both groups received basic treatment.The monotherapy group received nifedipine monotherapy to improve circulation,while the combination group used a dual drug of butylphthalide and nimergoline to improve circulation.After 3 months of treatment,the curative effects of the two groups were compared.Results After treatment,the levels of neurotransmitter indicators,such as acetylcholine,norepinephrine,dopamine,5-hydroxy tryptamine,and brain derived neurotrophic factor in the combination group were significantly higher than those in the monotherapy group(P<0.05).The levels of hemorheological indicators,such as plasma viscosity,low shear rate,middle shear rate,high shear rate,and hematocrit in the combination group were significantly lower than those in the monotherapy group(P<0.05).The scores of Montreal cognitive assessment and mini-mental state examination in the combination group were significantly higher than those of the monotherapy group(P<0.05).Conclusion The combination of butylphthalide and nimergoline in the treatment of VaD can further enhance brain tissue excitability and inhibitory neurotransmitter secretion levels,reduce blood viscosity,and improve neurological function.