中等强度有氧运动结合重复经颅刺激治疗阿尔茨海默病的疗效及其对患者认知功能及miR-129-5p的影响

Effects of moderate-intensity aerobic exercise combined with repetitive transcranial magnetic stimulation on cognitive function and miR-129-5p in patients with Alzheimer's disease

目的观察中等强度有氧运动结合重复经颅磁刺激治疗阿尔茨海默病的疗效,并探讨其对患者认知功能及miR-129-5p的影响。方法采用回顾性队列研究方法收集2021年1月至2023年12月在漯河市中心医院康复医学科及漯河医学高等专科学校第三附属医院康复治疗区就诊治疗的104例阿尔茨海默病患者的临床资料,依据不同治疗方案分为观察组和对照组各52例。观察组患者予以中等强度有氧运动联合重复经颅磁刺激治疗,对照组患者予以中等强度有氧运动结合重复经颅伪刺激治疗,两组患者均连续治疗3个月。采用简易精神状态检查量表(MMSE)评估疗效;采用阿尔茨海默病评定量表-认知分量表(ADAS-cog)和MMSE评估认知功能;采用酶联免疫吸附测定(ELISA)法检测血清炎症因子水平;采用实时荧光定量聚合酶链反应(RT-qPCR)法检测miR-129-5p表达水平;采用生活质量综合评定问卷(GQoL-74)和阿尔茨海默病生活质量量表(QoL-AD)评估生活质量;采用神经精神科问卷(NPI)评估精神状态。结果治疗3个月后,观察组患者的总有效率为94.23%,明显高于对照组的80.77%,差异有统计学意义(P<0.05);治疗3个月后,观察组患者的ADAS-cog及NPI评分分别为(22.40±2.20)分、(110.33±12.64)分,明显低于对照组的(26.77±2.59)分、(121.15±11.55)分,MMSE、GQoL-74及QoL-AD评分分别为(19.71±3.53)分、(72.33±9.08)分、(41.27±3.75)分,明显高于对照组的(18.15±2.40)分、(68.42±8.30)分、(38.13±4.12)分,差异均有统计学意义(P<0.05);治疗3个月后,观察组患者的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及白细胞介素-10(IL-10)水平分别为(10.66±1.19)ng/L、(9.05±1.07)mg/L、(8.49±1.17)ng/L,明显低于对照组的(13.30±1.38)ng/L、(11.12±1.20)mg/L、(10.35±1.31)ng/L,miR-129-5p为1.50±0.23,明显高于对照组的1.40±0.20,差异均有统计学意义(P<0.05)。结论中等强度有氧运动结合重复经颅磁刺激治疗可有效改善阿尔茨海默病患者认知功能,减少炎症反应及提高miR-129-5p水平,有助于改善患者精神状况并提高生活质量,临床应用效果好。

Objective To investigate the effects of moderateintensity aerobic exercise combined with repetitive transcranial magnetic stimulation on cognitive function and miR1295p in patients with Alzheimer's disease.Methods A retrospective cohort study was conducted to collect the clinical data of 104 patients of Alzheimer's disease who visited the Rehabilitation Medicine Department,Luohe Central Hospital and the Rehabilitation Treatment Area,the Third Affiliated Hospital of Luohe Medical College from January 2021 to December 2023 for treatment.According to different treatment programs,52 patients treated with moderateintensity aerobic exercise combined with repetitive transcranial pseudostimulation were included in the control group,and 52 patients treated with moderateintensity aerobic exercise combined with repetitive transcranial magnetic stimulation were included in the observation group.Both groups of patients were treated continuously for 3 months.The Minimental State Examination(MMSE)was used to assess treatment efficacy.The Alzheimer's Disease Assessment ScaleCognitive Subscale(ADAScog)and MMSE were used to evaluate cognitive function.Enzymelinked immunosorbent assay(ELISA)was used to detect serum inflammatory factors.Realtime quantitative polymerase chain reaction(RTqPCR)was used to measure miR1295p expression levels.The General Quality of Life Inventory74(GQoL74)and Quality of LifeAlzheimer's Disease(QoLAD)scales were used to assess quality of life.The Neuropsychiatric Inventory(NPI)was used to evaluate mental state.Results After 3 months of treatment,the effective rate of the observation group was 94.23%,which was significantly higher than 80.77%of the control group(P<0.05).The ADAScog and NPI scores of the observation group were(22.40±2.20)points and(110.33±12.64)points,which were significantly lower than(26.77±2.59)points and(121.15±11.55)points of the control group,respectively.MMSE,GQoL74,and QoLAD scores were(19.71±3.53)points,(72.33±9.08)points,and(41.27±3.75)points,respectively,which were significantly higher than(18.15±2.40)points,(68.42±8.30)points,and(38.13±4.12)points of the control group(P<0.05).The levels of tumor necrosis factorα(TNFα),Creactive protein(CRP),and interleukin10(IL10)in the observation group were(10.66±1.19)ng/L,(9.05±1.07)mg/L,and(8.49±1.17)ng/L,respectively,which were significantly lower than(13.30±1.38)ng/L,(11.12±1.20)mg/L,(10.35±1.31)ng/L of the control group,and the miR1295p level was 1.50±0.23,which was significantly higher than 1.40±0.20 of the control group,with statistically significant differences(P<0.05).Conclusion Moderateintensity aerobic exercise combined with repetitive transcranial magnetic stimulation can effectively improve cognitive function,reduce inflammation,increase miR1295p levels,and improve mental status and quality of life in patients with Alzheimer's disease,showing good clinical application effects.