胞磷胆碱联合奥拉西坦对老年高血压脑出血后认知功能障碍患者认知功能、神经递质水平及炎症应激反应的影响

Effect of Citicoline Combined with Oxiracetam on Cognitive Function,Neurotransmitter Level and Inflammatory Stress Response in Elderly Patients with Cognitive Dysfunction after Hypertensive Cerebral Hemorrhage

目的:探讨老年高血压脑出血(HICH)后认知功能障碍患者采用胞磷胆碱联合奥拉西坦治疗后,其神经递质、认知功能及炎症应激反应等变化情况。方法:采用随机数字表法将92例老年HICH后认知功能障碍患者分为对照组(奥拉西坦治疗,46例)和观察组(胞磷胆碱联合奥拉西坦治疗,46例)。观察两组治疗后的临床总有效率、认知功能、神经递质水平、炎症应激反应指标的变化情况。结果:观察组的临床总有效率高于对照组(P<0.05)。与对照组比较,观察组治疗2周后蒙特利尔认知评估量表(MoCA)、简易智力状态检查量表(MMSE)评分和血清甘氨酸(Gly)、γ-氨基丁酸(GABA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平升高,谷氨酸(Glu)、天冬氨酸(Asp)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、高迁移率簇蛋白B1(HMGB1)、丙二醛(MDA)水平下降(P<0.05)。结论:胞磷胆碱联合奥拉西坦治疗老年HICH后认知功能障碍患者,可有效改善患者的认知功能,可能与调节神经递质水平、减轻炎症应激反应有关。

Objective:To investigate the changes of neurotransmitters,cognitive function and inflammatory stress response in elderly patients with cognitive dysfunction after hypertensive cerebral hemorrhage(HICH)treated with citicoline combined with oxiracetam.Methods:According to the random number table method,92 elderly patients with cognitive dysfunction after HICH were divided into control group(oxiracetam treatment,46 cases)and observation group(citicoline combined with oxiracetam treatment,46cases).The total clinical effective rate,cognitive function,neurotransmitter level,inflammatory stress response index were observed between two groups after treatment.Results:The total clinical effective rate in observation group was higher than control group(P<0.05).Compared with control group,the scores of montreal cognitive assessment(MoCA),mini-mental state examination(MMSE)and the levels of serum glycine(Gly),γ-aminobutyric acid(GABA),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were increased,and the levels of glutamic acid(Glu),aspartic acid(Asp),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high mobility group protein B1(HMGB1)and malondialdehyde(MDA)were decreased in observation group 2 weeks after treatment(P<0.05).Conclusion:Citicoline combined with oxiracetam in the treatment of elderly patients with cognitive dysfunction after HICH,can effectively improve the cognitive function of patients,which may be related to regulating neurotransmitter levels and reducing inflammatory stress response.