Effect of magnesium valproate combined with donepezil on Alzheimer disease, urine alzheimer-associated neuronal thread protein and plasma lipoprotein-associated phospholipase A2

Cong Yannan; Sun Hairong; Zhang Jinbiao; Zhao Junwu; Tan Ming; Dong Liquan; Geng Na; Li Mengfan; Liu Xiaoxiao

doi:10.3760/j.issn.1673-4777.2018.07.017

Abstract：Objective To investigate the effect of magnesium valproate combined with donepezil on Alzheimer disease(AD),urine alzheimer-associated neuronal thread protein(AD7c-NTP) and plasma lipoproteinassociated phospholipase(Lp-PLA2).Methods Totally 120 AD patients admitted from January 2015 to December 2016 in Weihai Municipal Hospital were randomly divided into observation group and control group,with 60 cases in each group.The control group took doneprezil;the observation group took magnesium valproate and donepezil;the course of treatment was 8 weeks.The mini-Mental State Examination (MMSE) score,activity of daily living (ADL) score,Neuropsychiatric Inventory(NPI) score,levels of urine AD7c-NTP,plasma Lp-PLA2,interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP) and occurrence of adverse reactions were analyzed.Results After treatment,MMSE score and NPI score were significantly higher than those before treatment;MMSE score and NPI score in observation group were significantly higher than those in control group [(24.0 ± 4.7) vs (20.4 ± 4.3),(25 ± 9) vs (19 ± 9)] (P ＜ 0.05);ADL score was significantly lower than that before treatment;ADL score in observation group was significantly lower than that in control group[(19 ± 5) vs (26 ±6)] (P ＜0.05);levels of urine AD7c-NTP and plasma Lp-PLA2 were significantly lower than those before treatment;levels of urine AD7c-NTP and plasma Lp-PLA2 in observation group were significantly lower than those in control group[(1.8 ±0.6) μg/L vs (3.4 ±0.9) μg/L,(40 ±9) μg/L vs (58 ± 10) μg/L] (P ＜0.05);levels of IL-6,TNF-α and CRP were significantly lower than those before treatment;levels of IL-6,TNF-α and CRP in observation group were significantly lower than those in control group [(122 ± 59) pg/L vs (175 ± 84) pg/L,(154±14)pg/Lvs (174±17)pg/L,(3.3 ±0.8)mg/L vs (6.6 ±1.4)mg/L] (P＜0.05).There was no significant difference of incidence of adverse reactions between groups (P ＞ 0.05).Conclusion Magnesium valproate combined with donepezil treating Alzheimer disease can significantly improve cognitive function,ADL and neuropsychiatric status,reduce urine AD7c-NTP and plasma Lp-PLA2 level and inhibit inflammatory response.