丙戊酸镁联合多奈哌齐治疗对阿尔茨海默病精神行为状态、血清神经递质和细胞因子的影响

Effect of Magnesium Valproate Combined with Donepezil on Mental and Behavioral State,Serum Neurotransmitters and Cytokines in Patients with Alzheimer's Disease

目的探究丙戊酸镁联合多奈哌齐对阿尔茨海默病患者血清脂蛋白磷脂酶A2(Lp-PLA2)、铜蓝蛋白(CER)、脑源性神经营养因子(BDNF)水平及精神行为状态的影响。方法选择104例2020年8月至2023年8月就诊的阿尔茨海默病患者,以随机数字表法分为联合组、单药组,各52例。单药组接受盐酸多奈哌齐片治疗,联合组在单药组基础上接受丙戊酸镁片治疗,2组均治疗16周。观察2组治疗前、治疗16周后的精神行为状态评分、血清神经递质和细胞因子水平,以及治疗期间不良反应发生情况。结果治疗16周后,联合组和单药组简明蒙特利尔认知评估量表评分及血清γ-氨基丁酸、谷氨酸、5-羟色胺、CER、BDNF水平高于治疗前,且联合组高于单药组(P<0.05)。治疗16周后,联合组和单药组阿尔茨海默病评定量表-认知量表、Blessed-Roth行为量表、神经精神症状问卷评分及血清Lp-PLA2水平低于治疗前,且联合组低于单药组(P<0.05)。治疗期间,联合组、单药组不良反应总发生率分别为21.15%(11/52)、23.08%(12/52),组间比较无统计学差异(P>0.05)。结论丙戊酸镁联合多奈哌齐可有效提高阿尔茨海默病患者血清CER、BDNF及神经递质水平,降低血清Lp-PLA2水平,进而减轻神经细胞损伤,促进神经元信息的传递,有效改善其精神行为状态,且安全性良好。

Objective To explore the effects of Magnesium Valproate combined with Donepezil on serum lipoprotein phospholipase A2(Lp-PLA2),ceruloplasmin(CER)and brain-derived neurotrophic factor(BDNF)levels and mental and behavioral state of patients with Alzheimer's disease.Methods A total of 104 patients with Alzheimer's disease treated from August 2020 to August 2023 were randomly divided into combination group(n=52)and monotherapy group(n=52).The monotherapy group was treated with Donepezil Hydrochloride tablets,and the combination group was treated with Magnesium Valproate tablets on the basis of monotherapy group.Both groups were treated for 16 weeks.The scores of mental and behavioral status,the levels of serum neurotransmitters and cytokines,and the occurrence of adverse reactions during treatment were observed before and at 16 weeks after treatment.Results At 16 weeks after treatment,the scores of abbreviated Montreal Cognitive Assessment Scale and serum levels ofγ-aminobutyric acid,glutamic acid,5-hydroxytryptamine,CER and BDNF in combination group and monotherapy group were higher than those before treatment,and higher in the combination group than in the monotherapy group(P<0.05).At 16 weeks after treatment,the scores of Alzheimer's disease Assessment Scale-Cognitive Subscale,Blessed Roth Behavioral Scale,Neuropsychiatric symptom questionnaire and serum Lp-PLA2 levels in combination group and monotherapy group were lower than those before treatment,and lower in the combination group than in the monotherapy group(P<0.05).During treatment,the total incidence of adverse reactions in combination group and monotherapy group was 21.15%(11/52)and 23.08%(12/52),respectively,and there was no significant difference between the two groups(P>0.05).Conclusion Magnesium Valproate combined with Donepezil could effectively improve the levels of serum CER,BDNF and neurotransmitter in patients with Alzheimer's disease,and reduce the level of serum Lp-PLA2,thereby reducing the injury of nerve cells,promoting the transmission of neuronal information,and effectively improving their mental and behavioral state with good safety.