奥拉西坦联合阿托伐他汀对血管性认知障碍患者血清NO、MMP-9、ET-1水平的影响

摘要 目的：研究奥拉西坦联合阿托伐他汀对血管性认知障碍患者血清血清一氧化氮 (Nitric oxide, NO)、基质金属蛋白酶(Matrix metalloproteinases, MMP)-9和内皮素(Endothelin, ET)-1水平的影响。方法：选择2015年1月～2019年12月于我院诊治的70例血管性认知障碍患者,随机分为两组。对照组单独服用奥拉西坦,每天3次,每次0.8 g;观察组联合服用阿托伐他汀,每天晚上1次,每次20 mg。比较两组的简易精神智能量表（MMSE）和蒙特利尔认知评估量表（MoCA）评分,血清NO、MMP-9、ET-1水平、纤维蛋白原、总胆固醇、血浆黏度、甘油三酯水平。结果：治疗后,观察组的有效率明显高于对照组(P<0.05);两组的MMSE评分和Mo CA评分、血清NO水平明显升高,血清MMP-9和ET-1水平、纤维蛋白原、总胆固醇、血浆黏度、甘油三酯水平显著降低(P<0.05),且观察组的上述指标显著优于对照组(P<0.05)。结论：奥拉西坦联合阿托伐他汀对血管性认知障碍患者有较好的调脂作用,能改善其认知功能和血液流变学,其机制可能与改善血清NO、MMP-9、ET-1水平有关。     

Treatment with Oxiracetam or Choline Restores Cholinergic Biochemical and Pharmacological Activities in Striata of Decorticated Rats

Interruption of the corticostriatal pathway by undercutting the frontal cortex resulted after 2 weeks in a 40% reduction of basal acetylcholine (ACh) release in vivo, and in inhibition of the striatal sodium-dependent high-affinity uptake of choline (SDHACU) to the same extent. The lesion, too, completely prevented the rise (about 35%) in striatal ACh content induced by oxotremorine and apomorphine acting at muscarine and dopamine receptors, respectively. Acute intraperitoneal injections of 100 mg/kg of either oxiracetam or choline chloride resulted in time-dependent recovery of ACh output from the striata of decorticated rats to control levels. Oxiracetam also normalized the ex vivo striatal SDHACU activity of decorticated rats 2 h after administration without any effect in sham-operated rats. Oxiracetam or choline chloride administered before oxotremorine (0.8 mg/kg, i.p.) or apomorphine (1 mg/kg, i.p.) reinstated the ACh-increasing effect of these agonists. It is suggested that choline chloride acts directly simply by being the precursor for ACh, whereas oxiracetam may act indirectly, possibly by increasing the availability of choline chloride for ACh synthesis. Furthermore, the frontally decorticated rat could constitute a useful model for studying means to restore the deficit in striatal cholinergic neurotransmission.     

奥拉西坦联合尼莫地平对自发性蛛网膜下腔出血患者血清IGF-1, sICAM-1 及sVCAM-1 水平的影响

目的:探讨奥拉西坦联合尼莫地平对自发性蛛网膜下腔出血患者血清胰岛素样生长因子-1(Insulin like growth factor-1,IGF-1)、可溶性细胞间黏附分子-1(Soluble intercellular adhesion molecule-1,s ICAM-1)及可溶性血管间内皮细胞黏附分子-1(Soluble vascular adhesion molecule-1,s VCAM-1)水平的影响。方法:选取我院收治的自发性蛛网膜下腔出血患者46例,随机分配为实验组与对照组,每组23例。对照组患者给予尼莫地平治疗,实验组在对照组的治疗基础上加用奥拉西坦。比较治疗前后两组患者血清IGF-1、s ICAM-1及s VCAM-1水平,同时比较治疗结束后两组患者的临床总有效率。结果:与治疗前相比,两组患者治疗后血清IGF-1水平升高,s ICAM-1及s VCAM-1水平降低(P0.05);且与对照组相比,实验组患者血清IGF-1水平较高,s ICAM-1及s VCAM-1水平较低,临床总有效率较高(P0.05)。结论:奥拉西坦联合尼莫地平能够提高自发性蛛网膜下腔出血患者的临床疗效,其机制与提高患者血清IGF-1水平,降低s ICAM-1及s VCAM-1水平有关。     

针灸联合奥拉西坦治疗脑出血的疗效及对患者神经功能和炎性因子的影响

摘要 目的：探讨脑出血患者经针灸联合奥拉西坦治疗后的临床疗效。方法：选取2015年2月2018年7月期间我院收治的90例脑出血患者,根据随机数字表法将患者分为对照组（n=45）和研究组（n=45）,对照组给予奥拉西坦治疗,研究组在对照组的基础上联合针灸治疗,比较两组临床疗效、血肿体积、脑水肿体积、神经功能及炎性因子水平,记录两组治疗期间不良反应情况。结果：研究组治疗2个疗程后的临床总有效率为91.11%（41/45）,高于对照组的71.11%（32/45）（P<0.05）。治疗2个疗程后,两组患者的简易精神状态量表（MMSE）评分升高,且研究组高于对照组（P<0.05）;两组患者美国国立卫生院卒中量表（NIHSS）评分降低,且研究组低于对照组（P<0.05）;两组白介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）均下降,且研究组低于对照组（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。与治疗第1 d相比,两组治疗第7 d、治疗第28 d血肿体积呈先增大后缩小趋势（P<0.05）,脑水肿体积呈持续缩小趋势（P<0.05）;研究组治疗第28 d血肿体积、脑水肿体积小于对照组（P<0.05）。结论：针灸联合奥拉西坦治疗可有效改善脑出血患者的临床症状,减轻炎症反应及神经功能损害,安全性较好。     

Nootropic Drugs Positively Modulate α-Amino-3-Hydroxy-5-Methyl-4-Isoxazolepropionic Acid-Sensitive Glutamate Receptors in Neuronal Cultures

Micromolar concentrations of piracetam, aniracetam, and oxiracetam enhanced alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-stimulated 45Ca2+ influx in primary cultures of cerebellar granule cells. Nootropic drugs increased the efficacy but not the potency of AMPA and their action persisted in the presence of the voltage-sensitive calcium channel blocker nifedipine. Potentiation by oxiracetam was specific for AMPA receptor-mediated signal transduction, as the drug changed neither the stimulation of 45Ca2+ influx by kainate or N-methyl-D-aspartate nor the activation of inositol phospholipid hydrolysis elicited by quisqualate or (+-)-1-aminocyclopentane-trans-1,3-dicarboxylic acid. Piracetam, aniracetam, and oxiracetam increased the maximal density of the specific binding sites for [3H]AMPA in synaptic membranes from rat cerebral cortex. Taken collectively, these results support the view that nootropic drugs act as positive modulators of AMPA-sensitive glutamate receptors in neurons.