依达拉奉对重叠综合征伴认知障碍患者认知功能的影响

摘要

目的：探讨依达拉奉对重叠综合征（OS）伴认知障碍患者认知功能的影响。方法选择2009年1月—2013年8月华北理工大学附属医院呼吸科收治的 OS 伴认知障碍患者180例，按照随机数字表法分为对照组89例和观察组91例。对照组患者给予常规治疗，观察组患者在常规治疗基础上给予依达拉奉治疗，两组患者均治疗6个月。比较两组患者治疗前后血清同型半胱氨酸（ Hcy）、脑源性神经营养因子（ BDNF）水平及蒙特利尔认知评估量表（MoCA）评分，并观察治疗期间依达拉奉相关不良反应发生情况。结果治疗前两组患者血清 Hcy、BDNF 水平及MoCA 评分比较，差异无统计学意义（P ﹥0.05）；治疗后观察组患者血清 Hcy 水平低于对照组，血清 BDNF 水平和MoCA 评分均高于对照组（ P ﹤0.05）。Pearson 相关性分析结果显示，血清 Hcy 水平与 MoCA 评分呈负相关（ r ＝-1.240，P ﹤0.05），血清 BDNF 水平与 MoCA 评分呈正相关（r ＝0.620，P ﹤0.05）。治疗期间观察组患者未出现与依达拉奉相关的肝肾功能损伤及心脏损伤等不良反应。结论依达拉奉可能通过降低血清 Hcy 水平、升高 BDNF 水平而改善 OS 伴认知障碍患者的认知功能。%Objective To investigate the impact of edaravone on cognitive function of overlap syndrome patients complicated with cognition disorders. Methods From January 2009 to August 2013,a total of 180 overlap syndrome patients complicated with cognition disorders were selected in the Department of Respiratory,the Affiliated Hospital of North China University of Science and Technology,and they were divided into control group( n = 89) and observation group( n = 91) according to random number table. Patients of control group received conventional treatment,while patients of observation group received extra edaravone based on conventional treatment,both groups treated for 6 months. Serum levels of Hcy and BDNF, MoCA score before and after treatment were compared between the two groups,and incidence of edaravone related adverse reactions during treatment was recorded. Results No statistically significant differences of serum level of Hcy or BDNF,MoCA score was found between the two groups before treatment(P ﹥ 0. 05);after treatment,serum Hcy level of observation group was statistically significantly lower than that of control group,while serum BDNF level and MoCA score of observation group were statistically significantly higher than those of control group( P ﹤ 0. 05). Pearson correlation analysis showed that,serum Hcy level was negatively correlated with MoCA score(r = - 1. 240,P ﹤ 0. 05),while serum BDNF level was positively correlated with MoCA score(r = 0. 620,P ﹤ 0. 05). No one of observation group occurred any edaravone related liver or renal toxicity,or cardiac damage during treatment. Conclusion Edaravone can improve the cognitive function of overlap syndrome patients complicated with cognition disorders by reducing the serum Hcy level and rising the serum BDNF level.