标题：司来吉兰联合多巴胺制剂对帕金森病患者的治疗效果及血清BDNF、NGF、IGF-1水平的影响

      作者：康乐乐 1，苗婵婵 1，高海茸 2    1.延安大学附属医院神经内科，陕西 延安 716000；2.延安市人民医院神经内科，陕西 延安 716000

      卷次： 2023年34卷4期

      【摘要】 目的 探讨司来吉兰联合多巴胺制剂对帕金森病患者的治疗效果及血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)、胰岛素样生长因子-1 (IGF-1)水平的影响。方法 选择2018年1月至2021年1月延安大学附属医院收治的98例帕金森病患者为研究对象，按照随机数表法分为观察组和对照组各49例。对照组患者给予左旋多巴治疗，观察组患者在对照组治疗的基础上联合司来吉兰治疗，两组均持续治疗2个月。比较两组患者的临床疗效，治疗前后的血清BDNF、NGF、IGF-1水平、统一帕金森氏病综合评分量表(UPDRS)评分、Berg平衡量表(BBS)评分和治疗期间的不良反应发生情况。结果 治疗后，观察组患者的临床疗效总有效率为91.84%，明显高于对照组的73.47%，差异有统计学意义(P<0.05)；治疗后，两组患者血清BDNF、NGF、IGF-1水平均高于治疗前，观察组患者治疗后血清BDNF、NGF、IGF-1水平分别为(5.47±0.59) ng/mL、(148.71±16.03) ng/mL、(118.64±13.82) ng/mL，明显高于对照组的(4.85±0.62) ng/mL、(133.82±15.18) ng/mL、(101.02±15.54) ng/mL，差异均有统计学意义(P<0.05)；治疗后，两组患者UPDRS评分均明显低于治疗前，BBS评分均明显高于治疗前，观察组患者治疗后的UPDRS评分为(28.83±3.11)分，明显低于对照组的(34.06±3.45)分，BBS评分为(39.63±3.52)分，明显高于对照组的(30.18±3.34)分，差异均有统计学意义(P<0.05)；治疗期间，观察组和对照组患者的不良反应发生率分别为14.29%和10.20%，差异无统计学意义(P>0.05)。结论 司来吉兰联合多巴胺制剂对帕金森病可有效调节患者的血清BDNF、NGF、IGF-1水平，临床应用效果显著。
      【关键词】 帕金森病；左旋多巴；司来吉兰；脑源性神经营养因子；神经生长因子；胰岛素样生长因子-1；疗效；不良反应
      【中图分类号】 R742.5 【文献标识码】 A 【文章编号】 1003—6350（2023）04—0493—04

Therapeutic effects of selegiline combined with dopamine in the treatment of patients with Parkinson's diseaseand its effect on serum BDNF, NGF, and IGF-1 levels.
KANG Le-le 1, MIAO Chan-chan 1, GAO Hai-rong 2. 1. Departmentof Neurology, Affiliated Hospital of Yan'an University, Yan'an 716000, Shaanxi, CHINA; 2. Department of Neurology,Yan'an People's Hospital, Yan'an 716000, Shaanxi, CHINA
【Abstract】 Objective To study the therapeutic effects of selegiline combined with dopamine in the treatmentof patients with Parkinson's disease and its effect on serum levels of brain-derived neurotrophic factor (BDNF), nervegrowth factor (NGF), and insulin-like growth factor-1 (IGF-1). Methods A total of 98 patients with Parkinson's diseaseadmitted to the Affiliated Hospital of Yan'an University from January 2018 to January 2021 were selected as subjects,which were divided into an observation group and a control group according to random number table method, with 49 pa-tients in each group. Patients in the control group were treated with levodopa, and those in the observation group used sele-giline on the basis of treatment in the control group, both for 2 months. The clinical efficacy, the serum BDNF, NGF, andIGF-1 levels, Unified Parkinson's Disease Rating Scale (UPDRS) and Berg Balance Scale (BBS) scores before and aftertreatment, and the incidence of adverse reactions during treatment were compared between the two groups. Results Aftertreatment, the total effective rate in the observation group was 91.84%, which was significantly higher than 73.47% of thecontrol group (P<0.05). After treatment, the serum levels of BDNF, NGF, and IGF-1 in the two groups were higher than thosebefore treatment, and the levels after treatment in the observation group were (5.47 ±0.59) ng/mL, (148.71±16.03) ng/mL,(118.64±13.82) ng/mL, which were significantly higher than (4.85±0.62) ng/mL, (133.82±15.18) ng/mL, (101.02±15.54) ng/mL of the control group (P<0.05). After treatment, UPDRS scores were significantly lower in both groupsthan those before treatment, and BBS scores were significantly higher than those before treatment; the UPDRS score af-ter treatment in the observation group was (28.83±3.11) points, which was significantly lower than (34.06±3.45) pointsof control group; BBS score was (39.63±3.52) points, which was significantly higher than (30.18±3.34) points of thecontrol group; the differences were statistically significant (P<0.05). During treatment, the incidence of adverse reactionswas 14.29% in the observation group and 10.20% in the control group, respectively, with no statistically significant dif-ference between the two groups (P>0.05). Conclusion Selegiline combined with dopamine can effectively regulate theserum BDNF, NGF, and IGF-1 levels in patients with Parkinson's disease, and the clinical application is remarkable.
      【Key words】 Parkinson's disease; Levodopa; Selegiland; Brain-derived neurotrophic factor; Nerve growth factor;Insulin-like growth factor-1; Curative effect; Adverse reactions