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。

The relationship between the serum concentration of CHE,SOD and cognitive function in Alzheimer's disease versus vascular dementia

Objective： To study the relationship between huperzine A and the serum superoxide dismutase （SOD） and acetylcholine esterase （CHE） in outpatients with Alzheimer＇s disease （AD） or vascular dementia（VaD） . Methods： According to the American Psychiatry Association＇s Diagnostic and Statistical Manual classification（ DSM - Ⅳ ）, 39 patients with AD and 37 patients with VaD were recruited. Efficacy was assessed with Mini - mental State Examination （MMSE）. The serum SOD and CHE, were tested at baseline before treatment and 2, 4, 8, 12 weeks after treatment. All subjects were randomly devided into the 12 weeks Huperzine A treatment group and the control group. Results：At the endpoint of 12 weeks after treatment, the serum CHE level of the treatment was significantly lower than that of control group （209.2 ± 51.4） mg/L vs. （282.9 ± 49.7） mg/L, t = 6.26, P 〈 0.01], the serum SOD level was significantly higher than that of the control group （206.2 ± 29.4） mmol/L vs. （ 167.6 ± 27.7 ） mmol/L, t = - 5.80, P 〈 0.01 1. In the treatment group, the serum SOD level of VaD patients was higher than that of AD patients （228.0 ± 24.3 ） mmol/L vs. （ 196.0 ± 26.0 ） mmol/L , t = - 3.99, P 〈 0.01 ] and MMSE scores improved significantly（20.1 ± 5.8 vs. 15. 6 ±5.6,t = - 3.48 ,P 〈 0.01 ）. Conclusion：There may be different antioxidization metabolisms in different types of dementia. The efficacy of Huperzine A in VaD may be better than that in AD.