帕金森病血抗氧化系统的变化及临床意义

探讨帕金森病（ＰＤ）患者体内抗氧化系统水平及其在ＰＤ发病中的可能作用。方法观测了７０例ＰＤ患者和７０例正常人的血浆维生素Ｃ、Ｅ浓度（Ｐ－ＶＣ，Ｐ－ＶＥ），血浆及红细胞膜超氧化物歧化酶（Ｐ－ＳＯＤ，Ｅ－ＳＯＤ）活性，血浆及红细胞过氧化脂质（Ｐ－ＬＰＯ，Ｅ－ＬＰＯ）水平的变化。结果与正常对照组相比，ＰＤ患者的Ｐ－ＶＣ、Ｐ－ＶＥ浓度及Ｐ－ＳＯＤ、Ｅ－ＳＯＤ活性均明显降低，而Ｐ－ＬＰＯ、Ｅ－ＬＰＯ水平则显著增高。并且Ｐ－ＶＣ、Ｐ－ＶＥ、Ｅ－ＳＯＤ水平与ＰＤ患者的病情和病程呈负相关。结论提示ＰＤ患者可能存在血抗氧化系统缺陷而使内源性氧自由基堆积，导致黑质神经元退变     

帕金森病患者血液抗氧化功能的变化及多巴制剂与VitE对 …

目的 探讨帕金森病（ＰＤ）的抗氧化酶（ＳＯＤ）活性和过氧化脂质（ＬＰＯ）代谢水平的变化和多巴药物及ＶｉＴ对其的影响，找出反映氧化异常的客观生化指标。方法 对９６例ＰＤ患者动态检测了服用Ｌ－多巴和ＶｔＥ前后的血浆及红细胞膜超氧化物岐化酶（Ｐ－ＳＯＤ、Ｅ－ＳＯＤ）和谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）活性，血浆及红细胞过氧化脂质（Ｐ－ＬＰＯ、Ｅ－ＬＰＯ）及丙二醛（ＭＤＡ）的变化，并与２０例正常３人对照。     

阿尔茨海默病与血管性痴呆患者血浆SOD、CHE浓度和认知功能

目的通过石杉碱甲治疗痴呆,探讨血浆胆碱酯酶（CHE）、超氧化物歧化酶（SOD）浓度变化与认知功能改善的关系。方法对符合美国精神障碍诊断与统计手册第4版诊断标准的阿尔茨海默病（简称AD）39例,血管性痴呆（简称VaD）37例,随机分为石杉碱甲治疗组44例,对照组32例,在入组前、观察第2、4、8及12周时,测定其血浆胆碱酯酶（CHE）、超氧化物歧化酶（SOD）浓度及简易精神状态检查量表（MMSE）。结果治疗12周时,治疗组的CHE血浆浓度明显低于对照组[（209.2±51.4）mg/L,（282.9±49.7）mg/L,t=6.26,P〈0.01],治疗组SOD血浆浓度明显高于对照组[（206.2±29.4）mmol/L,（167.6±27.7）mmol/L,t=-5.80,P〈0.01];其中,治疗组内,VaD患者比AD患者的血浆SOD浓度高[（228.0±24.3）mmol/L,（196.0±26.0）mmol/L,t=-3.99,P〈0.01]、MMSE评分改善明显（20.1±5.8,15.6±5.6,t=-3.48,P〈0.01）,差异有显著的统计学意义。结论不同的痴呆病因可能具有不同的抗氧化物代谢过程,胆碱酯酶抑制剂（石杉碱甲）治疗血管性痴呆的效果优于治疗阿尔茨海默病。     

石杉碱甲治疗血管性痴呆的临床研究

目的：观察石杉碱甲治疗轻、中度血管性痴呆（VaD）的临床疗效和安全性。方法：78例轻、中度VaD患者随机分为两组。石杉碱甲组39例：男性24例,女性15例,年龄（71．8±7．2）岁;对照组39例：男性26例,女性13例,年龄（72．3±6．9）岁。石杉碱甲组给予石杉碱甲0．1mg,bid,口服;对照组给予维生素C100mg,bid,口服。两组总疗程为12周。采用简易精神状态检查表（MMSE）、临床痴呆程度量表（CDR）和日常生活能力量表（ADL）作为评价指标。结果：石杉碱甲治疗12周后MMSE、CDR及ADL分数分别较对照组和治疗前明显改善（P〈0．01）。结论：石杉碱甲可显著改善VaD患者的认知功能,且安全性良好。     

石杉碱甲片剂治疗21例阿尔采木病疗效观察

石杉碱甲片剂治疗２１例阿尔采木病疗效观察山东省济南市精神病防治中心（２５００３２）赵长英，李绍峰，陈学亮，韩美桂石杉碱甲（ＨｕｐｅｒｚｖｎｅＡ）系可逆性中枢乙酰胆碱酯酶抑制剂，其抑制强度是毒扁豆碱的３倍［１］，本药对记忆障碍有良好的改善作用［２、３］...     

脑梗塞患者血清中LPO,SOD水平与巴曲酶的影响

本文应用硫代巴比妥酸显色比色法和邻苯三酚自氧法测定８７例脑梗塞患者血清中ＬＰ０、ＳＯＤ含量，随机分组分别用巴曲酶和低分子右旋糖酐＋丹参治疗，并测定治疗后血清中ＬＰＯ、ＳＯＤ含量，研究证明脑梗塞患者血清中ＬＰＯ显著高于非脑血管病及健康对照者（Ｐ＜０．０１），而ＳＯＤ显著低于非脑血管病及健康对照者（Ｐ＜０．０１）。巴曲酶治疗后血清中ＬＰＯ明显低于治疗前（Ｐ＜０．０１），ＳＯＤ高于治疗前（Ｐ＜０．０５），而对照组无差异（Ｐ＞０．０５）。提示巴曲酶可抑制脑梗塞患者血清中ＬＰＯ产生，提高ＳＯＤ活性，具有保护神经细胞作用。     

石杉碱甲配合氟西汀对抑郁症记忆功能和疗效影响的研究

目的：探讨石杉碱甲对抑郁症患者记忆功能的影响。方法：将78例抑郁症患者随机分为单用药组（单用氟西汀治疗）和合用药组（氟西汀联合石杉碱甲治疗）各39例,疗程8周。于治疗前及治疗2、4和8周,采用韦氏记忆量表修订版（WMS-RC）测评记忆功能;采用汉密尔顿抑郁量表（HAMD）评定疗效。结果：两组记忆功能和HAMD评分治疗后均有明显改善,以合用药组较单用药组改善更为显著;记忆商总分显著提高（P〈0.05或P〈0.01）。结论：石杉碱甲能提高抑郁症患者的记忆功能,改善认知障碍,对抑郁症有较好的辅助或增效作用。     

石杉碱甲、尼莫地平及其联合治疗增龄相关记忆障碍的效果及其对血浆总抗氧化能力和血小板钙离子浓度的影响

目的探讨石杉碱甲、尼莫地平及其联合治疗增龄相关记忆障碍(AAMI)的效果及其对血浆总抗氧化能力(TAC)和血小板钙离子浓度的影响。方法AAMI患者140例,随机分为4组(每组35例),石杉碱甲(双益平)组口服石杉碱甲100μg3/日,尼莫地平组口服尼莫地平30mg3/日;联合治疗组口服石杉碱甲100μg2/日及尼莫地平30mg3/日;对照组口服维生素B610mg3/日;各组均连服6周。在治疗前、治疗后分别进行记忆功能[韦氏记忆量表(WMS)],血浆TAC和血小板游离钙浓度检测。结果治疗后,石杉碱甲组、尼莫地平组和联合治疗组WMS各项评分、血浆TAC水平及血小板钙离子浓度显著高于治疗前及对照组(均P<0.05),联合治疗组又明显高于石杉碱甲组和尼莫地平组(均P<0.05)。结论石杉碱甲、尼莫地平及其两者合用对AAMI有显著改善作用,以两者合用效果最好;并且都能提高血浆TAC水平及血小板钙离子浓度。     

自由基清除剂对糖尿病模型大鼠神经组织中自由基代谢影响的实验研究

本文分别测定了正常对照组、糖尿病模型组，用不同剂量超氧化物歧化酶（ＳＯＤ）治疗糖尿病模型大鼠坐骨神经组织中总ＳＯＤ（Ｔ－ＳＯＤ）、铜锌ＳＯＤ（Ｃｕ－Ｚｎ－ＳＯＤ）、过氧化脂质（ＬＰＯ）、丙二醛（ＭＤＡ）水平。结果：糖尿病大鼠神经组织中ＬＰＯ、ＭＤＡ高于正常对照组；Ｔ－ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ水平则低于对照组（Ｐ＜０．０１）。大剂量ＳＯＤ比小剂量ＳＯＤ提高Ｔ－ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ，降低ＬＰＯ、ＭＤＡ作用明显。提示糖尿病神经组织中自由基代谢异常是导致糖尿病神经病的原因之一，而外源性ＳＯＤ对糖尿病神经组织中自由基有清除作用。     

神经症患者超氧化物歧化酶、谷胱甘肽超氧化物酶及脂质超氧化物含量的变化

为研究氧自由基与神经症之间的关系，分别采用邻苯三酚自氧化法、二硫对硝基苯甲酸直接法、硫代巴比妥酸比色法，测定了８７例神经症和５５名健康人超氧化物歧化酶（ＳＯＤ）、谷胱甘肽超氧化物酶（ＧＳＨ－Ｐｘ）和脂质超氧化物（ＬＰＯ）含量。结果显示，神经症组ＳＯＤ与ＧＳＨ－Ｐｘ两种酶含量均低于对照组，神经症组治疗前低于治疗后；ＬＰＯ为治疗前高于治疗后，差异均有显著性。从单胺类的代谢与生成氧自由基的生化联系以及机体内ＳＯＤ、ＧＳＨ－Ｐｘ、ＬＰＯ之间的相互关系上对结果进行了分析，提示体内单胺类物质代谢过程中产生的氧自由基在神经症的病理过程中可能发挥一定的作用。     

阿尔茨海默病与血管性痴呆患者血浆同型半胱氨酸与超氧化物歧化酶的比较

目的探讨血浆同型半胱氨酸（Hcy）水平与超氧化物歧化酶（SOD）浓度和阿尔茨海默病（AD）与血管性痴呆（VaD）患者认知功能损害之间的关系。方法将入组病例分成AD组和VaD组，分别测定血浆Hcy、SOD水平并进行比较；采用简易智能状态量表（MMSE）评定认知功能水平。结果AD组Hcy浓度为（16．24±6．62）μmol／L，VaD组为（25．81±11．81）μmol／L，两组比较差异有统计学意义（P〈0．01）。AD组SOD浓度为（165．94±35．92）μmol／L，VaD组为（167．76±29．86）μmol／L，两组比较差异无统计学意义（P〉0．05）。AD组Hcy浓度与SOD水平呈负相关（r=-0．346，P〈0．05），VaD组SOD水平与年龄呈负相关（r=-0．358，P〈0．05），两组患者的MMSE评分与Hcy浓度呈负相关（r=-0．263，P〈0．01）。结论血浆Hcy、SOD水平可能是预测认知功能损害程度的一个重要生化指标。     

Changes in lipid peroxides and superoxide dismutase as incubation of in vitro erythrocytes with cerebrospinal fluids and the action of various scavengers of free radicals]

In this experiment, LPO increased and SOD reduced as the time pass when erythrocytes (RBC) and CSF were mixed and incubated. There was a negative relationship between LPO and SOD. LPO in RBC of arterial blood was higher than that of venous blood after incubation for 3 days (P less than 0.01). When arterial RBCs were incubated together with various scavengers of free radical (SOD catalase and histidine and mannitol), the production of LPO was less than that of arterial RBC incubation singly (P less than 0.01). The change of LPO was not reduced when sodium nitrite and arterial RBC incubated. The results demonstrated that the scavengers of free radicals could be eliminated free radical but failed with sodium nitrite.     

多奈哌齐治疗阿尔茨海默病的临床观察

目的探讨多奈哌齐单用与合用其他药物治疗阿尔茨海默病(AD)的临床疗效。方法将60例AD患者随机分为单用多奈哌齐(单用组)和综合治疗(合用组)，在治疗前、治疗后6周、12周和24周末分别进行简易智能状态检查(MMSE)评分和临床疗效评定。结果两组在治疗后6周和12周末MMSE评分和临床疗效无明显差异，在24周末合用组显著优于单用组。结论多奈哌齐单独使用和药物综合治疗AD短期疗效相仿，而远期疗效以综合治疗较好。     

Alpha-1-antichymotrypsin and oxidative stress in the peripheral blood from patients with probable Alzheimer disease: a short-term longitudinal study

To evaluate the stability and reproducibility of selected peripheral oxidative stress markers and their possible relation to cognitive performance, three different blood samples were taken at 7- to 10-day intervals from 11 patients with probable Alzheimer disease (AD) and 11 nondemented controls. Blood samples were also collected once from 6 patients with vascular dementia (VD). Alpha-1-antichymotrypsin (ACT), C-reactive protein (CRP), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), lactoferrin (LTF), and total lipid peroxidation (LPO) were then measured. Blood levels of ACT and GSH-Px were increased in AD patients but not in patients with VD. Levels of LTF, CRP, and LPO were comparable between AD patients and controls. Erythrocyte SOD activity was increased in AD patients. Blood levels of ACT negatively correlated with LPO levels and positively correlated with scores of the Global Deterioration Scale of AD patients. ACT might be implicated in controlling oxidative damage of blood lipids and their turnover during the progression of AD.     

Cognitive and neuroendocrine response to transdermal estrogen in postmenopausal women with Alzheimer's disease: results of a placebo-controlled, double-blind, pilot study.

Preliminary evidence from clinical studies indicates that treatment with estrogen augments cognitive function for women with Alzheimer's disease (AD). The neurobiology of estrogen, particularly its neuromodulatory and neuroprotective actions, provide a viable basis to support such cognition-enhancing effects. We conducted a placebo-controlled, double-blind, parallel-group design pilot clinical study to evaluate the cognitive and neuroendocrine response to estrogen administration for postmenopausal women with AD. Twelve women with probably AD of mild-moderate severity completed the study. During an eight week treatment period, six women received 0.05 mg/day dosage of 17 beta-estradiol via a skin patch and the remaining six wore a placebo skin patch. Subjects were randomized to equal distribution, and evaluated at baseline, at weeks 1, 3, 5, and 8 on treatment, and at weeks 9, 10, 11, and 13 off treatment. On each day of evaluation, cognition was assessed using a battery of neuropsychological tests, and blood samples were collected to measure plasma concentrations of estradiol and estrone. In addition, several neuroendocrine markers were measured in plasma to evaluate the relationship between estrogen-induced cognitive effects and fluctuations in the catecholaminergic and insulin-like growth factor systems. Significant effects of estrogen treatment were observed on attention (i.e. Stroop: number of self-corrections in the Interference condition, F[1,8] = 8.22, P < 0.03) and verbal memory (i.e., Buschke: delayed cued recall, F[3,30] = 4.31, P < 0.02). The salutary effects of estrogen on cognition were observed after the first week of treatment, and started to diminish when treatment was terminated. For women treated with estrogen, enhancement in verbal memory was positively correlated with plasma levels of estradiol (r = 0.96, P < 0.02) and negatively correlated with concentrations of insulin-like growth factor binding protein-3 (IGFBP-3) in plasma (r = -0.92, P < 0.03). Furthermore, a trend in the data was evident to suggest a negative relationship between plasma levels of insulin-like growth factor-1 (IGF-1) and verbal memory (r = -0.86, P = 0.06). Estrogen administration suppressed peripheral markers of the IGF system, as evidenced by a negative correlation between plasma concentration of estradiol and IGF-1 (r = -0.93, P < 0.03), and a trend for a similar relationship between plasma levels of estradiol and IGFBP-3 (r = -0.86, P = 0.06). With respect to the catecholamines assayed, norepinephrine was positively correlated with verbal memory (r = 0.95, P < 0.02) for women who were treated with estrogen. Furthermore, there was a trend to suggest a negative relationship between plasma epinephrine levels and the number of errors committed on a test of attention (r = -0.84, P = 0.07). In the placebo group, no significant effects of estrogen replacement were evident either on measures of cognition or on any of the neuroendocrine markers. The results of this study suggest that estrogen replacement may enhance cognition for postmenopausal women with AD. Furthermore, several markers of neuroendocrine activity may serve to index the magnitude of estrogen-induced facilitation on cognition. In addition, research findings from the present study will provide important information for the design of larger prospective clinical studies that are essential to definitively establish the therapeutic role of estrogen replacement for postmenopausal women with AD.     

艾斯能治疗阿尔茨海默病有效性及安全性的临床研究

目的　评价艾斯能治疗阿尔茨海默病 ( Alzheimer disease,AD)患者的有效性及安全性。方法　对 30例( MMSE≤ 2 6分 ) AD患者进行了多中心、开放、自身对照 1 6周临床试验 ,应用简易智能精神量表 ( MMSE)、AD评定量表 ( ADAS)及 Blessed-Roth痴呆量表判定疗效 ,检测患者生命体征及实验室指标 ,并进行安全性评价。结果　经艾斯能治疗 1 6周后 ,患者的认知功能 :MMSE较治疗前平均提高 3.9分 ,ADAS认知部分改善 5 .4分( P<0 .0 1 ,P<0 .0 5 ) ;患者的日常生活自理能力 :Blessed-Roth日常生活能力部分降低 1 .6分 ( P <0 .0 1 ) ;患者的精神行为异常 :ADAS的非认知行为部分减少 4 .2分 ,Blessed-Roth的人格部分降低 1 .4分 ( P<0 .0 5 ,P<0 .0 1 )。 5例 ( 1 6 % )出现轻度胆碱能兴奋性副作用。结论　艾斯能可改善 AD患者的认知功能、日常生活自理能力和精神行为异常 ,耐受性好 ,安全性高 ,其主要副作用为胆碱能兴奋性胃肠道反应     

急性脑梗塞患者红细胞免疫功能与血清SOD,LPO的变化

测定了３１例急性脑梗塞患者红细胞Ｃ３ｂ受体花环率（ＲＢＣ—Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（ＲＢＣ—ＩＣＲ）以及可能影响红细胞免疫粘附（ＲＣＩＡ）功能的血清脂质过氧化物（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）。结果表明，急性脑梗塞患者ＲＢＣ—Ｃ３ｂＲＲ明显降低，而ＲＢＣ—ＩＣＲ明显增高；血清ＳＯＤ含量减少，ＬＰＯ明显增高。ＲＢＣ—Ｃ３ｂＲＲ降低与血清ＬＰＯ增高呈显著负相关，与ＳＯＤ呈正相关。上述结果说明红细胞免疫功能降低与体内自由基代谢改变有关。     

石杉碱甲治疗脑器质性疾病的记忆和认知功能的疗效观察

目的探讨石杉碱甲治疗脑器质性疾病的记忆和认知功能的疗效.方法用石杉碱甲治疗脑器质性疾病64例,疗程八周.其中阿尔采木氏病(AD)23例,血管性痴呆(VD)41例.采用韦氏记忆商数(WMQ)、简易智能状态量表(MMSE)评定疗效.结果治疗后,AD、VD两组的(WMQ)与MMSE得分均较治疗前有明显改善(P＜0.05～0.1).结论石杉碱甲对治疗脑器质性疾病的记忆和认知功能有效.