普罗布考对高同型半胱氨酸血症并轻度认知障碍患者的影响研究

摘要

Objective To investigate the impact of probucol on hyperhomocysteinemia patients complicated with mild cognitive impairment. Methods A total of 92 hyperhomocysteinemia patients complicated with mild cognitive impairment were selected in the People's Hospital of Tangshan from December 2011 to December 2013,and they were divided into control group and observation group according to random number table,each of 46 cases. Patients of control group were given atorvastatin, while patients of observation group were given atorvastatin combined with probucol,both groups continually treated for 1 year. Blood lipids index( including TC,TG,LDL-C and HDL-C),Hcy,CRP,S100β protein,NSE,BDNF,NIHSS score, MMSE score,carotid artery IMT,IPA and unstable plaques detection rate before and after treatment were compared between the two groups,and the incidence of adverse reactions during treatment was recorded. Results No statistically significant differences of TC,TG,LDL-C,HDL-C,Hcy,CRP,S100β protein,NSE,BDNF,NIHSS score,MMSE score,carotid artery IMT,IPA or unstable plaques detection rate was found between the two groups(P > 0. 05);after treatment,TC,TG, LDL-C,Hcy,CRP,S100β protein,NSE,NIHSS score and carotid artery unstable plaques detection rate of observation group were statistically significantly lower than those of control group,HDL-C,BDNF and MMSE score of observation group were statistically significantly higher than those of control group,while carotid artery IMT and IPA of observation group were statistically significantly smaller than those of control group( P < 0. 05). No statistically significant differences of incidence of nausea or vomiting,dizziness or headache,anaphylaxis,liver or kidney dysfunction,or gastrointestinal reaction was found between the two groups during treatment( P > 0. 05). Conclusion Probucol has certain lipid - decreasing effect in treating hyperhomocysteinemia patients complicated with mild cognitive impairment,can effectively reduce the inflammatory cytokines level,improve the cognitive function and neurological function,shrink the carotid artery plaques and enhance the stability of plaques,and has relatively high safety.%目的 探讨普罗布考对高同型半胱氨酸血症并轻度认知障碍患者的影响.方法 选择河北省唐山市人民医院2011年12月—2013年12月收治的高同型半胱氨酸血症并轻度认知障碍患者92例,采用随机数字表法分为对照组和观察组,每组46例.对照组患者采用阿托伐他汀治疗,观察组患者在对照组基础上采用普罗布考治疗,两组患者疗程均为1年.比较两组患者治疗前后血脂指标〔 总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、S100β 蛋白、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、美国国立卫生研究院卒中量表(NIHSS)评分、简易精神状态评价量表(MMSE)评分,颈动脉内膜中层厚度(IMT)、内膜斑块面积(IPA)及易损斑块检出情况,记录两组患者治疗过程中不良反应发生情况.结果 两组患者治疗前TC、TG、LDL-C、HDL-C、Hcy、CRP、S100β 蛋白、NSE、BDNF、NIHSS评分、MMSE评分、颈动脉IMT、IPA及易损斑块检出率比较,差异无统计学意义(P>0.05);观察组患者治疗后TC、TG、LDL-C、Hcy、CRP、S100β 蛋白、NSE、NIHSS评分及颈动脉易损斑块检出率低于对照组,HDL-C、BDNF、MMSE评分高于对照组,颈动脉IMT、IPA小于对照组(P<0.05).两组患者治疗过程中恶心呕吐、头晕头痛、过敏反应、肝肾功能异常及胃肠道反应发生率比较,差异无统计学意义(P>0.05).结论 普罗布考用于治疗高同型半胱氨酸血症并轻度认知障碍降脂效果确切,可有效降低炎性因子水平并改善患者认知功能及神经功能,缩小颈动脉斑块并增强斑块稳定性,且安全性较高.