The Influence of Donepezil Combined with Nimodipine on Cerebral Perfusion Parameters,Cognition and Serum Lp-PLA2,BDNF,Ang1-7 Levels in Patients with Vascular Dementia

WANG Zhenkun; XU Liangjie

doi:10.16458/j.cnki.1007-0893.2025.06.003

Abstract：Objective To explore the application of donepezil combined with nimodipine in patients with vascular dementia.Methods A total of 102 patients with vascular dementia admitted to Kaifeng Hospital of Traditional Chinese Medicine from June 2020 to July 2023 were selected as the research subjects and randomly divided into the calcium antagonist group and the anticholinergic group,with 51 cases in each group.Patients in the calcium antagonist group were treated with nimodipine,while patients in the anticholinergic group were treated with donepezil in addition to nimodipine.The cerebral perfusion parameters[mean transit time(MTT),cerebral blood volume(CBV),and cerebral blood flow(CBF)],cognitive levels[Hasegawa Dementia Scale(HDS)and Montreal Cognitive Assessment(MoCA)scores],and serum-related factor levels[lipoprotein-associated phospholipase A2(Lp-PLA2),brain-derived neurotrophic factor(BDNF),and angiotensin 1-7(Ang1-7)]were compared between the two groups.Results After treatment,the MTT in both groups decreased compared with those before treatment,and the anticholinergic group was lower than the calcium antagonist group.The levels of CBF and CBV in both groups increased compared with those before treatment,and the anticholinergic group was higher than the calcium antagonist group.The differences were statistically significant(P<0.05).After treatment,the HDS and MoCA scores in both groups increased compared with those before treatment,and the anticholinergic group was higher than the calcium antagonist group.The differences were statistically significant(P<0.05).After treatment,the levels of serum Lp-PLA2 in both groups decreased compared with those before treatment,and the anticholinergic group was lower than the calcium antagonist group.The levels of serum BDNF and Ang1-7 levels in both groups increased compared with those before treatment,and the anticholinergic group was higher than the calcium antagonist group.The differences were statistically significant(P<0.05).Conclusion Donepezil combined with nimodipine can improve cerebral perfusion parameters and cognitive levels in patients with vascular dementia and regulate serum-related factor levels.