低强度脉冲超声刺激对帕金森病伴认知障碍患者认知、精神状态及神经递质水平的影响OA
Effects of low-intensity pulsed ultrasound stimulation on cognition,mental state and neurotransmitter levels in patients with Parkinson's disease and cognitive impairment
目的 探究低强度脉冲超声(LIPUS)刺激在帕金森病伴认知障碍患者中的应用效果.方法 选取2022年3月至2024年12月就诊的109例帕金森病伴认知障碍患者为研究对象,采用随机数字表法分为LIPUS组(n=55)与Sham组(n=54),两组均采用常规药物治疗,其中LIPUS组给予LIPUS刺激治疗,Sham组行假刺激(Sham刺激),持续治疗16周.比较两组的治疗效果、认知和精神状态[蒙特利尔认知评估量表(MoCA)、简易精神状态检查表(MMSE)]、神经递质、心理状态[贝克焦虑量表(BAI)、贝克抑郁量表(BDI)]、生活质量[帕金森病综合评分量表(UPDRS)]以及不良反应发生情况.结果 LIPUS组治疗总有效率为94.55%(52/55),高于Sham组的81.48%(44/54,P<0.05).相较于治疗前,两组治疗8、16周后MMSE、MoCA评分以及血清5-羟色胺、去甲肾上腺素、多巴胺水平均呈逐渐升高趋势,且LIPUS组高于Sham组(P<0.05).相较于治疗前,两组治疗8、16周后BAI、BDI及UPDRS评分均呈逐渐降低趋势,且LIPUS组低于Sham组(P<0.05).两组不良反应发生率比较无统计学差异(P>0.05).结论 LIPUS刺激治疗帕金森病伴认知障碍的效果显著,能够有效改善患者认知、精神和心理状态,提高生活质量,这可能与LIPUS刺激能调节患者神经递质表达水平有关,且具有良好的安全性.
Objective investigate the application effect of low-intensity pulsed ultrasound(LIPUS)stimulation on patients with Parkinson's disease complicated with cognitive impairment.Methods A total of 109 patients with Parkinson's disease and cognitive impairment who visited the hospital from March 2022 to December 2024 were selected as the research subjects.They were randomly divided into the LIPUS group(n=55)and the Sham group(n=54)using the random number table method.Both groups received conventional drug treatment.The LIPUS group was given LIPUS stimulation therapy,while the Sham group received Sham stimulation.The treatment lasted for 16 weeks.The therapeutic effects,cognitive and mental status[Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE)],neurotransmitters,psychological status[Beck Anxiety Inventory(BAI),Beck Depression Inventory(BDI)],quality of life[Unified Parkinson's Disease Rating Scale(UPDRS)],and adverse reactions were compared between the two groups.Results The total effective rate of LIPUS group was 94.55%(52/55),which was higher than that of the Sham group[(81.48%(44/54)](P<0.05).Compared with those before treatment,the scores of MMSE and MoCA,as well as the levels of serum 5-hydroxytryptamine,norepinephrine,and dopamine,gradually increased after 8 and 16 weeks of treatment in both groups,which were higher in the LIPUS group than in the Sham group(P<0.05).Compared with those before treatment,the scores of BAI,BDI,and UPDRS gradually decreased after 8 and 16 weeks of treatment in both groups,which were lower in the LIPUS group than in the Sham group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion LIPUS stimulation is effective in the treatment of Parkinson's disease with cognitive impairment.It can effectively improve the cognition,mental state and psychological state and enhance the quality of life of patients,which may be related to the regulation of neurotransmitter expression level by LIPUS stimulation,with good safety.
胡灿芳;曹立
上海交通大学医学院附属第六人民医院神经内科,上海 200233上海交通大学医学院附属第六人民医院神经内科,上海 200233
帕金森病认知障碍低强度脉冲超声精神状态神经递质生活质量
Parkinson's diseasecognitive impairmentlow-intensity pulsed ultrasoundmental stateneurotransmittersquality of life
《临床误诊误治》 2026 (3)
60-65,6
"科技创新行动计划"医学创新研究专项重点项目(21Y21901100)上海申康医院发展中心医企融合创新成果转化专项(SHDC2022CRD037)金山区医药卫生科技创新资金项目(2023-WS-61)
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