高压氧治疗对阿尔茨海默病患者认知功能及血清Humanin水平的影响
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摘要
目的探讨高压氧(HBO)治疗对阿尔茨海默病(AD)患者认知功能及血清Humanin水平的影响。方法选取2015年6月至2017年6月在泰安市中心医院神经内科住院的轻中度AD患者,共72例,采用随机数字表法随机分为对照组和HBO治疗组,每组各36例。对照组给予常规治疗,HBO治疗组在对照组的基础上给予HBO治疗,两组疗程均为2个月。比较两组患者治疗前后简易精神量表(MMSE)评分、蒙特利尔认知量表(MoCA)评分及血清Humanin水平变化情况。结果治疗前,对照组MMSE评分、MoCA评分及血清Humanin水平分别为(15.35±2.12)分,(17.08±2.73)分,(147.2±39.6)ng/L;HBO治疗组MMSE评分、MoCA评分及血清Humanin水平分别为(15.29±2.43)分,(17.16±2.61)分,(141.8±41.3)ng/L,两组比较均差异无统计学意义(t=0.11,-0.13, 0.57;均P>0.05);治疗2个月后,对照组MMSE评分、MoCA评分及血清Humanin水平分别为(18.57±3.59)分,(20.46±3.07)分,(180.9±48.1)ng/L,低于HBO治疗组[(20.68±2.97)分,(22.74±3.28)分,(216.5±52.9)ng/L],差异具有统计学意义(t=-2.72,-3.05,-2.99;均P<0.01);血清Humanin水平与MMSE评分、MoCA评分均呈正相关(r=0.628,0.691;均P<0.05)。结论 HBO可改善AD患者的认知功能,其作用机制可能与升高血清Humanin的水平有关。
Objective To investigate the effect of hyperbaric oxygen(HBO) on cognitive function and serum Humanin expression in patients with Alzheimer′s disease(AD). Methods From June 2015 to June 2017, 72 patients with mild to moderate AD admitted to the Neurology of Taian Central Hospital were selected. The patients were divided into control group and HBO treatment group by random number table method, each group with 36 patients. The control group was given conventional treatments and HBO treatment group was treated with HBO based on the conventional treatments, both groups were treated for 2 months. Mini-mental state examination(MMSE) scores, Montreal Cognitive Assessment(MoCA)scores and serum levels of Humanin in the two groups were compared before and after treatment. Results Before treatment, the MMSE score, MoCA score and serum Humanin level of the control group were(15.35±2.12) points,(17.08±2.73) points,(147.2±39.6) ng/L, respectively. The MMSE score, MoCA score and serum Humanin level in the HBO treatment group were(15.29±2.43) points,(17.16±2.61) points,(141.8±41.3) ng/L, respectively, there were no significant differences between the two groups(t=0.11,-0.13, 0.57, all P>0.05). After treatment, the MMSE score, MoCA score and serum Humanin level of the control group were(18.57±3.59)points,(20.46±3.07)points,(180.9±48.1)ng/L, which were lower than those in the HBO treatment group [(20.68±2.97)points,(22.74±3.28)points,(216.5±52.9)ng/L, respectively], the differences were significant(t=-2.72,-3.05,-2.99,all P<0.01). Serum Humanin level was positively correlated with MMSE score(r=0.628, P<0.05), and MoCA score(r=0.691, P<0.05). Conclusion Hyperbaric oxygen can improve the cognitive function of AD patients, and the mechanism may be related to the increased serum levels of Humanin.
Objective To investigate the effect of hyperbaric oxygen(HBO) on cognitive function and serum Humanin expression in patients with Alzheimer′s disease(AD). Methods From June 2015 to June 2017, 72 patients with mild to moderate AD admitted to the Neurology of Taian Central Hospital were selected. The patients were divided into control group and HBO treatment group by random number table method, each group with 36 patients. The control group was given conventional treatments and HBO treatment group was treated with HBO based on the conventional treatments, both groups were treated for 2 months. Mini-mental state examination(MMSE) scores, Montreal Cognitive Assessment(MoCA)scores and serum levels of Humanin in the two groups were compared before and after treatment. Results Before treatment, the MMSE score, MoCA score and serum Humanin level of the control group were(15.35±2.12) points,(17.08±2.73) points,(147.2±39.6) ng/L, respectively. The MMSE score, MoCA score and serum Humanin level in the HBO treatment group were(15.29±2.43) points,(17.16±2.61) points,(141.8±41.3) ng/L, respectively, there were no significant differences between the two groups(t=0.11,-0.13, 0.57, all P>0.05). After treatment, the MMSE score, MoCA score and serum Humanin level of the control group were(18.57±3.59)points,(20.46±3.07)points,(180.9±48.1)ng/L, which were lower than those in the HBO treatment group [(20.68±2.97)points,(22.74±3.28)points,(216.5±52.9)ng/L, respectively], the differences were significant(t=-2.72,-3.05,-2.99,all P<0.01). Serum Humanin level was positively correlated with MMSE score(r=0.628, P<0.05), and MoCA score(r=0.691, P<0.05). Conclusion Hyperbaric oxygen can improve the cognitive function of AD patients, and the mechanism may be related to the increased serum levels of Humanin.
引文
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[2] Wolters FJ,Koudstaal PJ,Hofman A,et al.Serum apolipoprotein E is associated with long-term risk of Alzheimer′s disease:the rotterdam study[J].Neurosci Lett,2016(617):139-142.
[3] Kumar A,Singh A,Ekavali.A review on Alzheimer′s disease pathophysiology and its management:an update[J].Pharmacol Rep,2015,67(2):195-203.
[4] 杨鹏,岳阳,周效宝,等.阿尔茨海默病患者脑电功率值特征分析[J/CD].中华诊断学电子杂志,2015,3(1):36-40.
[5] Boussi-Gross R,Golan H,Volkov O,et al.Improvement of memory impairments in poststroke patients by hyperbaric oxygen therapy[J].Neuropsychology,2015,29(4):610-621.
[6] Matsuoka M.Protective effects of Humanin and calmodulin-like skin protein in Alzheimer′s disease and broad range of abnormalities[J].Mol Neurobiol,2015,51(3):1232-1239.
[7] Association AP.Diagnostic and statistical manual of mental disorders (DSM-5?)[M] .Washington:American Psychiatric Pub,2013:611-614.
[8] Dubois B,Feldman HH,Jacova C,et al.Research criteria for the diagnosis of Alzheimer′s disease:revising the NINCDS-ADRDA criteria[J].Lancet Neurol,2007,6(8):734-746.
[9] 李伟,肖世富.阿尔茨海默病诊断标准的演变及评价[J/CD].中华诊断学电子杂志,2015,3(2):114-117.
[10] 贾阳娟,韩凝,王美蓉,等.MoCA与MMSE在急性缺血性卒中后认知障碍评估中的应用[J].中华行为医学与脑科学杂志,2017,26(1):46-50.
[11] Mittal K,Katare DP.Shared links between type 2 diabetes mellitus and Alzheimer′s disease:A review[J].Diabetes Metab Syndr,2016,10(2 Suppl 1):S144-S149.
[12] Alzheiner′s Association.2017 Alzheimer′s disease facts and figures[J].Alzheimer′s & Dementia,2017,13(4):325-373.
[13] Shapira R,Solomon B,Efrati S,et al.Hyperbaric oxygen therapy ameliorates pathophysiology of 3xTg-AD mouse model by attenuating neuroinflammation[J].Neurobiol Aging,2018(62):105-119.
[14] Zhao BS,Pan YY,Wang ZY,et al.Hyperbaric oxygen pretreatment improves cognition and reduces hippocampal damage via p38 mitogen-activated protein kinase in a rat model[J].Yonsei Med J,2017,58(1):131-138.
[15] 王晖霖,唐建梅.高压氧对阿尔茨海默病患者血清雌激素水平的影响[J].中国医药导报,2011,8(5):26-28.
[16] 高聚,姜华,宛丰,等.高压氧联合多奈哌齐治疗阿尔茨海默病的疗效及对血清内皮素-1的影响[J].神经损伤与功能重建,2017,12(3):269-271.
[17] Gong Z,Tas E,Muzumdar R.Humanin and age-related diseases:a new link?[J].Front Endocrinol (Lausanne),2014(5):210.
[18] Zhang XP,Zhang QL,Du YF.A novel rattin expression in the brain of the rat model of patients′ vascular dementia[J].J Neurol Sci Neurophysiol,2013,30(2):249-256.
[19] Liu W,Zhang XP,Yang DL,et al.Humanin attenuated the change of voltage-dependent potassium currents in hippocampal neurons induced by anoxia[J].CNS Neurosci Ther,2014,20(1):95-97.
[20] Han K,Jia N,Zhong Y,et al.S14G-humanin alleviates insulin resistance and increases autophagy in neurons of APP/PS1 transgenic mouse[J].J Cell Biochem,2018,119(4):3111-3117.
[21] Alam MP,Bilousova T,Spilman P,et al.A small molecule mimetic of the humanin peptide as a candidate for modulating NMDA-induced neurotoxicity[J].ACS Chem Neurosci,2018,9(3):462-468.
[22] Cui AL,Zhang YH,Li JZ,et al.Humanin rescues cultured rat cortical neurons from NMDA-induced toxicity through the alleviation of mitochondrial dysfunction[J].Drug Des Devel Ther,2017(11):1243-1253.