法舒地尔联合瑞舒伐他汀治疗血管性痴呆对认知功能、C-反应蛋白及氧化应激的影响

doi:10.12092/j.issn.1009-2501.2018.10.011

中国临床药理学与治疗学 ›› 2018, Vol. 23 ›› Issue (10): 1153-1158.doi: 10.12092/j.issn.1009-2501.2018.10.011

法舒地尔联合瑞舒伐他汀治疗血管性痴呆对认知功能、C-反应蛋白及氧化应激的影响

陈娟燕^1,2，宋水江¹，徐冬娟²，徐琼²，李鸿飞²

¹浙江大学医学院附属第二医院神经内科，杭州 310009，浙江； ²东阳市人民医院神经内科，东阳 322100，浙江

收稿日期:2018-04-25 修回日期:2018-06-24 出版日期:2018-10-26 发布日期:2018-10-25
通讯作者: 宋水江，男，博士，教授，研究方向：脑血管疾病。 E-Mail:chenjuanyan@tom.com
作者简介:陈娟燕，女，本科，研究方向：神经内科。 Tel：0571-87783777 E-mail：371509645@qq.com

Effects of fasudil combined with rosuvastatin in the treatment of vascular dementia on patients' cognitive function, C-reactive protein and oxidative stress

CHEN Juanyan^1,2, SONG Shuijiang ¹, XU Dongjuan², XU Qiong ², LI Hongfei ²

¹ Department of Neurology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China; ² Department of Neurology, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China

Received:2018-04-25 Revised:2018-06-24 Online:2018-10-26 Published:2018-10-25

摘要/Abstract

摘要：

目的: 研究血管性痴呆（VD）给予法舒地尔联合瑞舒伐他汀治疗对其认知功能、C-反应蛋白及氧化应激的影响。方法: 选取184例VD患者为研究对象，按随机数表法分为瑞舒伐他汀组与联合用药组（法舒地尔+瑞舒伐他汀），各92例。比较两组治疗前后简易精神状态量表（MMSE）、蒙特利尔认知功能量表（MoCA）与日常生活能力量表（ADL）评分、C-反应蛋白（CRP）水平、丙二醛（MDA）、血清同型半胱氨酸（Hcy）与超氧化物歧化酶（SOD）水平、血脂指标（TC、TG、LDL-C、HDL-C）水平、临床疗效及不良反应发生率。结果: 联合用药组治疗总有效率（93.48%）显著高于瑞舒伐他汀组（82.61%），差异有统计学意义（P<0.05）；治疗后，联合用药组MMSE、MoCA与ADL量表积分明显高于瑞舒伐他汀组，CRP、MDA、Hcy、TC、TG、LDL-C水平显著低于瑞舒伐他汀组，SOD水平明显高于瑞舒伐他汀组，差异均有统计学意义（P<0.05）。不良反应发生率无统计学意义（P>0.05）。结论: 法舒地尔联合瑞舒伐他汀治疗VD更有利于改善患者认知功能与日常生活能力，降低C-反应蛋白水平与氧化应激反应，改善血脂指标，临床疗效显著，且安全性高。

关键词: 血管性痴呆, 法舒地尔, 瑞舒伐他汀, 认知功能, C-反应蛋白, 氧化应激

Abstract:

AIM: To investigate the effects of fasudil combined with rosuvastatin in the treatment of vascular dementia (VD) on patients' cognitive function, C-reactive protein and oxidative stress. METHODS: One hundred and eighty-four VD patients were selected as study subjects. They were divided into the rosuvastatin group and the combined drug group (fasudil + rosuvastatin) according to the random number table method. Each group contains 92 cases. MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment) and ADL (Activities of Daily Living) scores, the level of CRP (C-reactive protein), MDA (malondialdehyde), Hcy (serum homocysteine) and SOD (superoxide dismutase), as well as blood lipid index (TC, TG, LDL-C, HDL-C) levels, clinical efficacy and incidence of adverse reaction were compared between the two groups before and after treatment. RESULTS:The total effective rate of the combined drug group (93.48%) was significantly higher than that of the rosuvastatin group (82.61%), and the difference was statistically significant (P<0.05). After treatment, the MMSE, MoCA and ADL scores of the combined drug group were significantly higher than that of the rosuvastatin group, while the level of CRP, MDA, Hcy, TC, TG and LDL-C was significantly lower than that of the rosuvastatin group, and the SOD level was significantly higher than that of the rosuvastatin group, which were of statistically significant difference (P<0.05). There was no significant difference in the incidence of adverse reaction (P>0.05). CONCLUSION: Fasudil combined with rosuvastatin in the treatment of VD can improve patients' cognitive function and daily living ability, reduce oxidative stress response and the level of C-reactive protein, and improve patients' blood lipid index. This method is of significant clinical efficacy and high safety.

Key words: vascular dementia, fasudil, rosuvastatin, cognitive function, C-reactive protein, oxidative stress

中图分类号:

R743

陈娟燕，宋水江，徐冬娟，徐琼，李鸿飞. 法舒地尔联合瑞舒伐他汀治疗血管性痴呆对认知功能、C-反应蛋白及氧化应激的影响[J]. 中国临床药理学与治疗学, 2018, 23(10): 1153-1158.

CHEN Juanyan, SONG Shuijiang, XU Dongjuan, XU Qiong, LI Hongfei. Effects of fasudil combined with rosuvastatin in the treatment of vascular dementia on patients' cognitive function, C-reactive protein and oxidative stress[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(10): 1153-1158.

参考文献

［1］Afzal S, Bojesen SE, Nordestgaard BG. Reduced 25-hydroxyvitamin D and risk of Alzheimer's disease and vascular dementia［J］. Alzheimers Dementia, 2014, 10(3): 296-302.
［2］张潇,曾鼎华.普罗布考联合瑞舒伐他汀治疗血管性痴呆的临床观察［J］.中国药房, 2017, 28(5): 649-652.
［3］Utkan T, Yazir Y, Karson A, et al. Etanercept improves cognitive performance and increases eNOS and BDNF expression during experimental vascular dementia in streptozotocin-induced diabetes［J］. Curr Neurovasc Res, 2015, 12(2): 135-146.
［4］岳蕴华,白旭东,张小宁,等.普罗布考联合阿托伐他汀对脑梗死患者血清hs-CRP、ox-LDL、MMP-9水平及颈动脉斑块的影响［J］.中国神经精神疾病杂志,2014,40(11):641-645.
［5］李晓凤,朱伟,王薇.盐酸法舒地尔治疗急性缺血性脑卒中的临床观察［J］.中华老年心脑血管病杂志,2009,11(8):628.
［6］李波,刘微微,沃金善.瑞舒伐他汀对代谢综合征患者血清血管生成素2和炎症因子水平的影响［J］.中国全科医学,2012,15(21):2402-2404.
［7］华先平,杨勇,娄国平,等.瑞舒伐他汀对颈动脉粥样硬化患者颈动脉内中膜厚度及血清炎症因子的影响［J］.中国循环杂志,2011,26(3):198-201.
［8］中华医学会精神病学分会. 中国精神障碍分类与诊断标准第三版(精神障碍分类)［J］. 中华精神科杂志, 2001,34(3): 1006-7884.
［9］宋淑霞,孟宪玲.法舒地尔对老年急性缺血性脑卒中患者神经功能缺损和血液流变学的影响［J］.中国老年学杂志,2012,32(5):1043-1045.
［10］中华医学会神经病学分会. 血管性痴呆诊断标准草案［J］.中华神经科杂志, 2002, 35(4):246.
［11］Barker R, Ashby EL, Wellington D, et al. Pathophysiology of white matter perfusion in Alzheimer's disease and vascular dementia［J］. Brain,2014,137(Pt 5):1524-1532.
［12］卢昌均,周哲屹,刘国成,等.血管性痴呆发病机制的研究进展［J/CD］. 中华脑科疾病与康复杂志: 电子版,2014,4(3):41-44.
［13］刘春丽,陈虹,姜勇,等.松果菊苷对血管性痴呆大鼠行为学、氧自由基以及胆碱能神经递质代谢速率的影响［J］.中国药理学通报,2013,29(7): 1035-1036.
［14］Gustaw RK, Kowalczuk K, Stryjecka ZM. Lipids' peroxidation markers in Alzheimer's disease and vascular dementia［J］. Geriatr Gerontol Int, 2010,10(2): 161-166.
［15］林正,余智,曾博,等.［Gly14］-Humanin减轻大鼠颅脑外伤后氧化应激及细胞凋亡［J］.中国神经精神疾病杂志,2016,42(3):180-183.
［16］Sachdev P. Homocysteine, cerebrovascular disease and brain atrophy［J］. J Neurol Sci, 2004, 226 (1/2): 25-29.
［17］Gibson CL, Srivastava K, Sprigg N, et al. Inhibition of Rho-kinase protects cerebral barrier from ischemia-evoked injury through modulations of endothelial cell oxidative stress and tight junctions［J］. J Neurochem,2014, 129 (5): 816-826.
［18］顾燕红,付顺昆,乔青燕,等.法舒地尔对HK-2细胞氧化应激及内质网应激的影响［J］.临床和实验医学杂志,2018,17(6):586-589.
［19］Santos DB, Colle D, Moreira EL, et al. Probucol, a lipidlowering drug，prevents cognitive and biochemical changes in mice［J］. Neuroscience, 2015, 284(12): 590-600.
［20］Jones PH, Davidson MH, Stein EA, et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR Trial)［J］. Am J Cardiol, 2003,92(2): 152-160.
［21］刘文铠,蔡志雄,周晓燕,等.盐酸法舒地尔联合低分子肝素对缺血性脑卒中患者APTT、PT、FIB及治疗效果的影响［J］.中国老年学杂志,2017,37(14):3463-3465.
［22］Fukuta T, Asai T, Sato A, et al. Neuroprotection against cerebral ischemia/reperfusion injury by intravenous administration of liposomal fasudil［J］. Pharm, 2016,506 (1/2): 129-137.

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法舒地尔联合瑞舒伐他汀治疗血管性痴呆对认知功能、C-反应蛋白及氧化应激的影响

Effects of fasudil combined with rosuvastatin in the treatment of vascular dementia on patients' cognitive function, C-reactive protein and oxidative stress

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