阿格列汀联合高压氧舱内运动意念对糖尿病无症状脑梗死功能损害的疗效观察

Efficacy of Alogliptin combined with motor imagery under hyperbaric oxygen on function impairment in diabetic patients with silent cerebral infarction

摘要:

目的 评估阿格列汀联合高压氧舱内运动意念对糖尿病无症状脑梗死（SCI）患者功能损害的疗效。方法 选取60 例新诊断2 型糖尿病SCI 患者为研究对象，将研究对象随机分为阿格列汀治疗组（A 组）和阿格列汀联合高压氧舱内运动意念组（B 组），每组30 例。治疗前后进行神经功能缺损程度和蒙特利尔认知评估量表评估，ELISA 测血清GP Ⅵ和尿11- 脱氢血栓素B2（11-DH-TXB2）水平，Western blot 检测微管相关蛋白2（MAP-2）的表达。结果 与A 组相比，B 组患者神经功能缺损程度、GP Ⅵ、11-DH-TXB2 及MAP-2 表达水平降低（P <0.05），而B 组患者MoCA 评分高于A 组，其中视空间/ 执行能力、注意力与集中评分、综合评分增高（P <0.05），计算、抽象思维、语言能力、记忆力及定向力评分比较，差异无统计学意义（P >0.05），治疗前后两组组内差异呈时间依赖性。结论 阿格列汀联合高压氧舱内运动意念可更好地促进糖尿病SCI 患者血栓溶解吸收和脑损伤恢复，改善神经认知功能。

Abstract:

Objective To evaluate the curative effect of Alogliptin combined with motor imagery under hyperbaric oxygen on function impairment in diabetic patients with silent cerebral infarction (SCI). Methods Sixty newly-diagnosed type 2 diabetic patients complicated with SCI were included. The patients were divided into two treatment groups: Alogliptin treatment group (group A, n = 30) and Alogliptin combined with motor imagery under hyperbaric oxygen treatment group (group B, n = 30). The degree of neurological defects and Montreal Cognitive Assessment Scale (MoCA) scores were evaluated at baseline and 6 months after treatment. Serum GP VI and urine 11-DH-TXB2 levels were determined by ELISA. The expression of cytoskeleton microtubule associated protein (MAP-2) was determined by Western blot. Results Compared to the group A, the severity of neurofunctional defects, serum GP VI, 11-DH-TXB2 and MAP-2 levels were significantly lower in the group B (P < 0.05); while MoCA scores were higher in the group B, among which the visuospatial/executive function score, attention and concentration score, and comprehensive score in the group B significantly increased (P < 0.05). The sub-scores of calculation, abstract thinking, language competence, memory and orientation, and comprehensive score were also higher in the group B but the differences were not statistically significant (P > 0.05). Intra-group comparisons revealed a time-dependent effect of treatment. Conclusions The treatment of Alogliptin combined with motor imagery under hyperbaric oxygen can better promote thrombolysis and absorption of thrombi and recovery of brain damage, and improve neurocognitive function.