首页|脑苷肌肽联合还原型谷胱甘肽和多巴丝肼治疗老年帕金森病患者的临床研究

脑苷肌肽联合还原型谷胱甘肽和多巴丝肼治疗老年帕金森病患者的临床研究

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目的 观察脑苷肌肽注射液联合还原型谷胱甘肽注射剂和多巴丝肼片治疗老年帕金森病伴轻度认知障碍(PD-MCI)患者的临床疗效和安全性.方法 将老年PD-MCI患者随机分为对照组和试验组.2组患者均给予多巴丝肼片抗帕金森病治疗.在此基础上,对照组给予还原型谷胱甘肽每次1.2 g,静脉滴注,qd;试验组在对照组治疗的基础上,给予脑苷肌肽每次10 mL,静脉滴注,qd.2组患者均连续治疗4周.比较2组患者的临床疗效、血清活化T细胞趋化因子(RANTES)、α-突触核蛋白(α-syn)、脑源性神经营养因子前体蛋白(pro-BDNF)、过氧化氢酶(CAT)、总超氧化物歧化酶(T-SOD)水平以及认知功能、生存质量,并观察药物不良反应的发生情况.结果 试验组入组48例,脱落3例,最终有45例纳入统计分析;对照组入组48例,脱落6例,最终有42例纳入分析.治疗后,试验组和对照组的总有效率分别为93.33%(42例/45例)和76.19%(32例/42例),在统计学上差异有统计学意义(P<0.05).治疗后,试验组和对照组的 RANTES 分别为(25.57±4.62)和(30.29±4.92)pg·mL-1,α-syn 分别为(3.08±0.76)和(3.74±1.09)μg·L-1,pro-BDNF 分别为(144.65±17.54)和(182.26±15.75)ng·mL-1,CAT 分别为(168.54±10.64)和(160.48±9.74)kU·L-1,T-SOD 分 别 为(123.75±20.54)和(110.18±22.66)kU·L-1,蒙特利尔认知评估量表评分分别为(25.08±2.75)和(23.14±2.64)分,39项帕金森病生存质量问卷评分分别为(45.84±8.42)和(50.34±7.62)分,在统计学上差异均有统计学意义(均P<0.05).试验组发生的药物不良反应有心律失常、头晕、发冷和胃肠道不适;对照组发生的药物不良反应有一过性血小板减少和心律失常.试验组和对照组的总药物不良反应发生率分别为8.89%和4.76%,在统计学上差异无统计学意义(P>0.05).结论 脑苷肌肽注射液联合还原型谷胱甘肽注射剂和多巴丝肼片治疗老年PD-MCI患者的临床疗效确切,其能显著增强神经保护、抗氧化的作用,改善患者的认知功能及生存质量,且不增加药物不良反应发生率.
Clinical trial of cattle encephalon glycoside and ignotin injection combined with reduced glutathione and levodopa and benserazide hydrochloride tablets in the treatment of elderly patients with Parkinson's disease
Objective To observe the clinical efficacy and safety of cattle encephalon glycoside and ignotin injection combined with reduced glutathione injection and levodopa and benserazide hydrochloride tablets in the treatment of elderly patients with Parkinson's disease complicated with mild cognitive impairment(PD-MCI).Methods Elderly patients with PD-MCI were randomly divided into control group and treatment group.Two groups were treated with levodopa and benserazide hydrochloride tablet for anti-Parkinson's disease therapy,and on this basis,the control group was given intravenous drip of reduced glutathione 1.2 g(qd),and the treatment group was given intravenous drip of cattle encephalon glycoside and ignotin injection 10 mL(qd)on the basis of the control group.Both groups of patients were treated continuously for 4 weeks.The clinical efficacy,serum regulated upon activation,normal T cell expressed and secreted(RANTES),α-synuclein(α-syn),brain-derived neurotrophic factor precursor protein(pro-BDNF),catalase(CAT),total superoxide dismutase(T-SOD),cognitive function and quality of life were compared between both groups,and the adverse drug reactions were observed.Results In treatment group,48 cases were enrolled but 3 cases were lost,thus 45 cases were finally included in the analysis.In control group,48 cases were enrolled but 6 cases were lost,thus 42 cases were included in the analysis.After treatment,the total effective rates in treatment and control groups were 93.33%(42 cases/45 cases)and 76.19%(32 cases/42 cases)respectively(P<0.05).After treatment,RANTES levels in treatment group and control group were(25.57±4.62)and(30.29±4.92)pg·mL-1;α-syn levels were(3.08±0.76)and(3.74±1.09)μg·L-1;pro-BDNF levels were(144.65±17.54)and(182.26±15.75)ng·mL-1;CAT levels were(168.54±10.64)and(160.48±9.74)kU·L-1;T-SOD levels were(123.75±20.54)and(110.18±22.66)kU·L-1;Montreal Cognitive Assessment Scale scores were(25.08±2.75)and(23.14±2.64)points;and 39-item Parkinson's Disease Quality of Life Questionnaire scores were(45.84±8.42)and(50.34±7.62)points,respectively.The differences of above indexes were statistically significant between two groups(all P<0.05).The adverse drug reactions in treatment group were arrhythmia,dizziness,chills and gastrointestinal discomfort.The adverse drug reactions in control group were transient thrombocytopenia and arrhythmia.The total incidences of adverse drug reactions in treatment group and control group were 8.89%and 4.76%wthout significant difference(P>0.05).Conclusion Cattle encephalon glycoside and ignotin injection combined with reduced glutathione injection and levodopa and benserazide hydrochloride tablets has exact clinical efficacy in the treatment of elderly patients with PD-MCI,and it can significantly enhance the neuroprotective and antioxidant effects and improve the cognitive function and quality of life of patients,and it does not increase the incidence rate of adverse drug reactions.

cattle encephalon glycoside and ignotin injectionreduced glutathione injectionlevodopa and benserazide hydrochloride tabletParkinson's diseasemild cognitive impairmentneurological functionclinical efficacysafety evaluation

臧婷臻、郝单单、康德强、吴玉芙

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清华大学医院内科,北京 100084

脑苷肌肽注射液 还原型谷胱甘肽注射剂 多巴丝肼片 帕金森病 轻度认知功能障碍 神经功能 临床疗效 安全性评价

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(9)
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