多奈哌齐联合叶酸、维生素B12治疗对老年阿尔茨海默病伴高同型半胱胺酸血症患者血清炎性因子、HCY、NSE及脑神经递质的影响

摘要

Objective: To investigate the effects of donepezil combined with folic acid and vitamin B12 on the levels of serum inflammatory factors, Hcy, NSE and neurotransmitters in elderly patients with Alzheimer's disease (AD) complicated with hyperhomocysteinemia.Methods: A total of 98 elderly patients with AD complicated with hyperhomocysteinemia were randomly divided into control group (n=48) and observation group (n=50) according to the random data table method.Patients in the control group were treated with donepezil.On this basis, the patients in the observation group were treated with folic acid and vitamin B12.The treatment lasted for 3 months.Before and after treatment, the levels of serum inflammatory factors (TNF-α, IL-6 and hs-CRP), Hcy, NSE and brain neurotransmitter (5-HT, NE and DA) were compared between the two groups.Results: Before treatment, the levels of TNF-α, IL-6, hs-CRP, Hcy, NSE, 5-HT, NE and DA of the control group and the observation group were not statistically significant (P>0.05).Compared with the results before treatment, the levels of TNF-α, IL-6, hs-CRP, Hcy and NSE in the two groups were significantly lower (P<0.05), and the levels of the observation group were significantly lower than those of the control group.The difference was statistically significant (P<0.05);Compared with the results before treatment, the levels of 5-HT, NE and DA in the two groups were significantly increased (P<0.05), and the levels of observation group were significantly higher than that of the control group.The difference was statistically significant (P<0.05).Conclusions: Donepezil combined folic acid and vitamin B12 in treatment of AD with hyperhomocysteinemia, which can effectively reduce the body's inflammatory response, levels of Hcy and NSE and elevate levels of brain neurotransmitters, has important clinical significance.%目的:探讨多奈哌齐联合叶酸,维生素B12治疗老年阿尔茨海默病(AD)伴高同型半胱胺酸血症,对患者血清炎性因子、Hcy、NSE及脑神经递质的影响.方法:98例老年阿尔茨海默病伴高同型半胱胺酸血症患者随机分为对照组(n=48)和观察组(n=50).对照组给予多奈哌齐治疗,在此基础上,观察组给予多奈哌齐联合叶酸和维生素B12治疗,均治疗3个月.比较两组治疗前后血清炎性因子(TNF-α、IL-6及hs-CRP)、Hcy、NSE及脑神经递质(5-HT、NE及DA)水平的变化.结果:治疗前,对照组与观察组的TNF-α、IL-6、hs-CRP、Hcy、NSE、5-HT、NE及DA水平比较,差异无统计学意义(P>0.05).治疗后两组TNF-α、IL-6、hs-CRP、Hcy、NSE水平较组内治疗前均显著降低(P<0.05),且观察组水平显著低于对照组,差异有统计学意义(P<0.05);与组内治疗前相比,两组治疗后5-HT、NE及DA水平均显著升高(P<0.05),且观察组显著高于对照组,差异有统计学意义(P<0.05).结论:多奈哌齐与叶酸,维生素B12联合治疗老年阿尔茨海默病伴高同型半胱胺酸血症,可有效降低机体炎症性反应,下调Hcy、NSE水平,升高脑神经递质水平,具有重要临床意义.