丙戊酸镁联合多奈哌齐在治疗老年痴呆中的效果分析

Analysis of the effect of magnesium valproate combined with donepezil in the treatment of senile dementia

目的 分析老年痴呆患者应用丙戊酸镁联合多奈哌齐治疗后其认知功能及血清神经营养因子(BDNF)、铜蓝蛋白(CER)、微小核糖核酸-132(miRNA-132)水平等指标变化情况。方法 选取2020年10月至2022年10月衡水市第七人民医院收治的110例老年痴呆患者作为研究对象,以随机数字表法将其分为试验组和对照组,各55例。对照组给予盐酸多奈哌齐片,试验组在此基础上给予丙戊酸镁片,治疗疗程均为3个月。比较两组认知功能、精神行为症状、炎性因子、神经功能及安全性。结果与治疗前比较,两组治疗3个月后的简明蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)评分、BDNF、CER、miRNA-132水平均升高,试验组高于对照组更高,差异有统计学意义(t=12.322、9.215、20.914、18.728、11.721,P<0.05)。与治疗前比较,两组治疗3个月后的神经精神症状问卷(NPI)评分、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均降低,试验组低于对照组,差异有统计学意义(t=10.522、6.995、14.639、6.516,P<0.05)。治疗期间,两组安全性比较差异无统计学意义(P>0.05)。结论 老年痴呆患者应用丙戊酸镁联合多奈哌齐治疗后其血清BDNF、CER、miRNA-132水平升高,神经功能改善,机体炎症减轻,认知功能及神经行为症状进一步改善,且安全性良好。

Objective To analyze the changes of cognitive function and serum levels of neuro-trophic factor(BDNF),ceruloplasmin(CER)and microribonucleic acid-132(miRNA-132)after magnesium valproate combined with donepezil treatment in elderly patients with dementia.Methods 110 cases of senile dementia patients were admitted to the Seventh People’s Hospital of Hengshui City from October 2020 to Octo-ber 2022.They were randomly divided into an experimental group and a control group,with 55 cases in each group determined by the random number table method.The control group received donepezil hydrochloride tab-lets,while the test group received magnesium valproate tablets.The treatment course for both groups was 3 months.The study compared cognitive function,psychobehavioral symptoms,inflammatory factors,neurologi-cal function,and safety between the two groups.Results Compared to pre-treatment scores,the Brief Mon-treal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE),BDNF,CER and miRNA-132 levels in both groups increased after 3 months of treatment.The levels in the test group were higher than those in the control group,with statistical significance(t=12.322,9.215,20.914,18.728 and 11.721,P<0.05).Similarly,compared to pre-treatment levels,the scores of the neuropsychiatric symptom questionnaire(NPI),interleukin-1β(IL-1β),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)levels in both groups decreased after 3 months of treatment.The test group had lower levels than the control group,with statis-tical significance(t=10.522,6.995,14.639,6.516,P<0.05).There were no statistical differences in safety be-tween the two groups during treatment(P>0.05).Conclusion Alzheimers disease patients treated with magne-sium valproate combined with donepezil showed increased levels of BDNF,CER,and miRNA-132.They also experienced improved neurological function,reduced inflammation in the body,and further enhancement of cognitive function and neurobehavioral symptoms.Additionally,this treatment had a favorable safety profile.