美金刚对抑郁发作的非痴呆性血管性认知功能障碍患者的影响

doi:10.3969/j.issn.1006-5725.2019.16.025

实用医学杂志 ›› 2019, Vol. 35 ›› Issue (16): 2628-2632.doi: 10.3969/j.issn.1006-5725.2019.16.025

美金刚对抑郁发作的非痴呆性血管性认知功能障碍患者的影响

肖成业, 杨国帅, 余丹, 程启慧, 孙荣道

海口市人民医院神经内科（海口 570208）

收稿日期:2019-01-28 出版日期:2019-08-27 发布日期:2019-08-27
通讯作者: 杨国帅 E-mail：youngester4213@sina.com
基金资助:
海南省自然科学基金项目（编号：20158272）; 海口市重点科技计划项目（编号：2014-073）

Effect of memantine on depression episode patients with vascular cognitive impairment no dementia

XIAO Chengye, YANG Guoshuai, YU Dan, CHENG Qihui, SUN Rongdao

Department of Neurology, the People′s Hospital of Haikou, Haikou 570208, China

Received:2019-01-28 Online:2019-08-27 Published:2019-08-27
Contact: YANG Guoshuai E-mail： youngester4213@sina.com

摘要/Abstract

摘要： 目的探讨美金刚对抑郁发作的非痴呆性血管性认知功能障碍（vascular cognitive impairment no dementia,VCIND）患者的影响,为临床上治疗抑郁发作的VCIND患者提供思路。方法选择2017年3月至2018年9月在海口市人民医院神经内科就诊的抑郁发作的VCIND患者,随机分为美金刚组和对照组。对照组采用常规治疗3个月,美金刚组在常规治疗基础上从入院后开始给予美金刚口服治疗,第一周5 mg/d,以后每周递增5 mg,第4周达到20 mg/d,持续治疗3个月。治疗3个月后对两组患者进行汉密尔顿抑郁量表（HAMD）-24评分、前额叶部位的N-乙酰天门冬氨酸（NAA）/肌酸（Cr）比值、胆碱复合物（Cho）/Cr比值评定。同时,采用蒙特利尔认知评估量表（MoCA）对两组患者治疗后的认知功能进行评定。结果与对照组比较,美金刚组治疗后HAMD-24评分降低,NAA/Cr值、Cho/Cr值明显改善,差异有统计学意义（P < 0.05）。与对照组比较,美金刚组治疗后MoCA总分及各分项视空间与执行功能、命名、定向力、注意力、语言功能、抽象概括能力、记忆力较对照组明显升高,差异有统计学意义（P < 0.01）。结论抑郁发作的VCIND患者细胞代谢水平降低,美金刚减轻患者的抑郁症状和改善认知功能可能与提高细胞代谢水平,促进细胞间信号传导有关。

关键词: 美金刚, 非痴呆性血管性认知功能障碍, 抑郁发作, 预后

Abstract: Objective To investigate the effect of memantine on depressive episode patients with vascular cognitive impairment no dementia （VCIND）, and to provide ideas for clinical treatment of depressive episode patients with VCIND. Methods From March 2017 to September 2018, depressive episode patients with VCIND were randomly divided into memantine group and control group. The control group received routine treatment for 3 months. The memantine group received oral treatment of memantineon the basis of routine treatment from the time of admission, with 5 mg/d in the first week, and then increase by 5 mg per week. At 4 week, it reached 20 mg/d and continued treatment for 3 monthsAfter 3 months of treatment, the two groups of patients were evaluated with Hamilton depression scale （HAMD）-24 score, N-acetyl aspartate （NAA）/Creatine, Cr） ratio and choline-containing compounds （CHO）/Cr ratio in the prefrontal cortex. At the same time, Montreal Cognitive Assessment （MOCA） was used to evaluate the cognitive function of the two groups of patients after treatment. Results Compared with the control group, HAMD-24 score in memantine group decreased after treatment, NAA/Cr value and Cho/Cr value were significantly improved, and the difference was statistically significant （P < 0.05）. Compared with the control group, the MoCA total score and visual space, executive function, naming, orientation, attention, language function, abstract generalization ability and memory of each sub-item in memantine group were significantly higher than those in the control group after treatment, and the difference was statistically significant （P < 0.01）. Conclusion The cellular metabolic level of depressive episode patients with VCIND is reduced. Memantine can reduce depressive symptoms and improve cognitive function of patients, which may be related to improving cellular metabolism level and promoting intercellular signal transmission.

Key words: memantine, vascular cognitive impairment no dementia, depressive episode, prognosis

肖成业, 杨国帅, 余丹, 程启慧, 孙荣道. 美金刚对抑郁发作的非痴呆性血管性认知功能障碍患者的影响[J]. 实用医学杂志, 2019, 35(16): 2628-2632.

XIAO Chengye, YANG Guoshuai, YU Dan, CHENG Qihui, SUN Rongdao. Effect of memantine on depression episode patients with vascular cognitive impairment no dementia[J]. The Journal of Practical Medicine, 2019, 35(16): 2628-2632.

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美金刚对抑郁发作的非痴呆性血管性认知功能障碍患者的影响

Effect of memantine on depression episode patients with vascular cognitive impairment no dementia

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