新疆医科大学学报

目的 探讨脑深部电刺激联合甘露特钠治疗阿尔茨海默病的疗效及对血清趋化因子CX3CL1及ApoE4水平的影响。方法 选取2023年8月-2024年8月绵阳市中心医院收治的阿尔茨海默病96例患者为研究对象，采用随机数字表法将其分成研究组(脑深部电刺激联合甘露特钠治疗，48例)和对照组(脑深部电刺激，48例),比较两组患者治疗前后认知功能、神经精神症状、生活质量、事件相关电位(ERP-P300)、趋化因子(C-X3-C基序)配体1(CX3CL1)、载脂蛋白E4(ApoE4)水平变化情况。结果 治疗前，两组患者简易精神状态检查表(MMSE)评分、MoCA评分、阿尔茨海默病行为病理评定量表(AD-BEHAVE)评分、日常生活活动能力量表(ADL)评分、ERP-P300指标、CX3CL1水平、ApoE4相对表达量比较，差异无统计学意义(P>0.05);治疗后，与对照组相比，研究组患者MMSE评分、MoCA评分、ADL评分、P3波幅、CX3CL1水平均升高，AD-BEHAVE评分、N1潜伏期、N2潜伏期、P2潜伏期、P3潜伏期、ApoE4水平均降低(P<0.05)。结论 以脑深部电刺激联合甘露特钠对AD患者进行治疗，可以有效改善其认知功能、神经精神症状，提高生活质量，调节ERP-P300,促进CX3CL1分泌，抑制ApoE4表达，临床疗效优于单一脑深部电刺激。

Objective To investigate the efficacy of deep brain electrical stimulation combined with sodium glycyrrhizinate in the treatment of Alzheimer′s disease(AD) and its effect on the levels of serum chemokines(C-X3-C motif) ligand 1(CX3CL1) and apolipoprotein E4(ApoE4). Methods 96 patients with AD admitted to the hospital from August 2023 to August 2024 were selected as the research subjects. The patients were randomly divided into a study group(48 cases treated with deep brain electrical stimulation combined with sodium glycyrrhizinate) and a control group(48 cases treated with deep brain electrical stimulation combined). The changes in cognitive function, neurological and psychiatric symptoms, quality of life, ERP-P300, CX3CL1and ApoE4levels before and after thetreatment were compared between the 2 groups. Results Before thetreatment, there was no significant difference in MMSE score, MoCA score, AD-BEHAVE score, ADL score, ERP-P300 index, CX3CL1 level and ApoE4 relative expression between the 2 groups of thepatients(P>0.05). After the treatment, compared with the control group, the patients in the study group had higher MMSE scores, MoCA scores, ADL scores, P3 wave amplitude and CX3CL1 levels, while AD-BEHAVE scores, N1 latency, N2 latency, P2 latency, P3 latency and ApoE4 relative expression levels were lower(P<0.05). Conclusion The combination of deep brain electrical stimulation and sodium glycyrrhizinate can effectively improve cognitive function, neurological and psychiatric symptoms, enhance quality of life, regulate ERP-P300, promote CX3CL1 secretion and inhibit ApoE4 expression in AD patients.