山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (4): 38-44.doi: 10.6040/j.issn.1671-7554.0.2021.1381
赵海龙1,2,王皓2,方雨晴2,毛飞2,赵张宁2,田祥奇2,徐新荣2,王敏3,李秀华2
ZHAO Hailong1,2, WANG Hao2, FANG Yuqing2, MAO Fei2, ZHAO Zhangning2, TIAN Xiangqi2, XU Xinrong2, WANG Min3, LI Xiuhua2
摘要: 目的 观察艾地苯醌联合治疗帕金森病抑郁(PDD)患者的疗效,探讨艾地苯醌对PDD患者的神经保护机制。 方法 选择PDD患者68例,按随机数字表法分为对照组和观察组,每组34例。对照组接受多巴丝肼片和吡贝地尓缓释片治疗,多巴丝肼片初始剂量为0.125 g/次,3次/d,最高≤0.75 g/d,口服。吡贝地尔缓释片初始剂量50 mg/次,1次/d,最大剂量50 mg/次,3次/d,口服,连续治疗12周。观察组在对照组基础上加用艾地苯醌片,30 mg/次,3次/d,口服,连续治疗12周。监测两组患者汉密尔顿抑郁量表(HAMD)及其因子分、汉密尔顿焦虑量表(HAMA)及其因子分、统一帕金森评分量表-Ⅲ(UPDRS-Ⅲ)、帕金森病睡眠量表(PDSS)、简易精神状态检查量表(MMSE)、帕金森病生活质量问卷(PDQ-39)、外周血超氧化物歧化酶(SOD)变化情况。 结果 治疗后两组HAMD总分及各项因子均较治疗前降低,除体质量减轻和日夜变化外,观察组HAMD总分及焦虑/躯体化、认知障碍、阻滞、睡眠障碍和绝望感五项因子评分低于对照组(P<0.05);治疗后两组HAMA总分及精神性焦虑和躯体性焦虑两项因子分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗后两组UPDRS-Ⅲ评分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗后两组PDSS评分均较治疗前增高(P<0.05),且观察组高于对照组(P<0.05);治疗后两组MMSE评分均较治疗前增高(P<0.05),且观察组高于对照组(P<0.05);治疗后两组PDQ-39评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗12周后,观察组血SOD水平较治疗前增高,对照组血SOD水平较治疗前降低,两组SOD水平差异有统计学意义(P<0.05)。 结论 艾地苯醌联合治疗能够明显减轻PDD患者的抑郁症状,改善患者运动症状和部分非运动症状,增加PDD患者外周血SOD水平,提高生活质量。
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