目的 观察多奈哌齐治疗阿尔茨海默病的临床疗效,并探讨其对β淀粉样蛋白、炎性因子的影响.方法 选取2015年2月—2017年1月广元市第二人民医院收治的阿尔茨海默病患者68例,采用随机数字表法分为对照组和观察组,每组34例.对照组患者给予常规治疗,观察组患者在对照组基础上给予多奈哌齐;两组患者均连续治疗24周.比较两组患者治疗后12、24周临床疗效,治疗前及治疗后12、24周认知障碍严重程度及血清β淀粉样蛋白、炎性因子水平;观察两组患者治疗期间不良反应发生情况.结果 观察组患者治疗后12、24周临床疗效优于对照组(P<0.05).治疗前两组患者认知障碍严重程度比较,差异无统计学意义(P>0.05);治疗后12、24周观察组患者认知障碍严重程度轻于对照组(P<0.05).治疗前两组患者血清β淀粉样蛋白1-28(Aβ1-28)、β淀粉样蛋白1-40(Aβ1-40)、β淀粉样蛋白1-42(Aβ1-42)水平比较,差异无统计学意义(P>0.05);治疗后12、24周观察组患者血清Aβ1-28、Aβ1-40水平低于对照组,Aβ1-42水平高于对照组(P<0.05).治疗前两组患者血清白介素1β(IL-1β)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后12、24周观察组患者IL-1β、IL-6、TNF-α水平低于对照组(P<0.05).两组患者治疗期间均未出现明显不良反应.结论 多奈哌齐治疗阿尔茨海默病的临床疗效确切,可有效减轻患者认知障碍严重程度,调节β淀粉样蛋白的表达,减轻炎性反应,且安全性较高.%Objective To observe the clinical effect of donepezil on Alzheimer's disease,to investigate its impact on amyloid β-peptide and inflammatory cytokines.Methods A total of 68 patients with Alzheimer's disease were selected in the Second People's Hospital of Guangyuan from February 2015 to January 2017,and they were divided into control group and observation group,each of 34 cases.Patients in control group received conventional treatment,while patients in observation group received donepezil based on conventional treatment;both groups continuously treated for 24 weeks.Clinical effect 12 weeks and 24 weeks after treatment,cognitive impairment severity,serum levels of amyloid β-peptide and inflammatory cytokines before treatment,12 weeks and 24 weeks after treatment were compared between the two groups,and incidence of adverse reactions was observed during the treatment.Results Clinical effect in observation group was statistically significantly better than that in control group 12 weeks and 24 weeks after treatment(P<0.05).No statistically significant differences of cognitive impairment severity was found between the two groups before treatment(P>0.05),while cognitive impairment severity in observation group was statistically significantly milder than that in control group 12 weeks and 24 weeks after treatment, respectively(P<0.05).No statistically significant differences of serum level of Aβ1-28,Aβ1-40 or Aβ1-42 was found between the two groups before treatment(P>0.05);12 weeks and 24 weeks after treatment,serum levels of Aβ1-28 and Aβ1-40 in observation group were statistically significantly lower than those in control group,while serum Aβ1-42 level in observation group was statistically significantly higher than that in control group,respectively(P<0.05).No statistically significant differences of serum level of IL-1β,IL-6 or TNF-α was found between the two groups before treatment(P>0.05), while serum levels of IL-1β,IL-6 and TNF-α in observation group were statistically significantly lower than those in control group 12 weeks and 24 weeks after treatment(P<0.05).No one in the two groups occurred obvious adverse reactions during the treatment.Conclusion Donepezil has certain clinical effect in treating Alzheimer's disease,can effectively relieve the cognitive impairment severity,adjust the expression of amyloid β-peptide,relieve the inflammatory reaction,with relatively high safety.
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