The Study Of Estrogen Level And Cognitive Function Of The Elderly Male Patients With Vascular Dementia Before And After Drug Intervention

BackgroundVascular dementia is a group of cognitive impairment syndromemainly caused by all kinds of cerebrovascular disease, its causes is complex, its harm is serious, and it can early prevent and control. Currently about estrogen effects on cognitive function, the results are inconsistent. Huperzine A is a reversible cholinesterase inhibitor, through a variety of ways to raise the level of acetylcholine in the brain and function, the study found the change of acetylcholine in vivo gonadal axis have an impact, there is no relevant report whether Huperzine A effect the level of estradiol (E2) of the patients with vascular dementia at home and abroad.Objectives1. To investigate the serum levels of estradiol in elderly male patients with vascular dementia.2. To explore the correlation between serum E2level and cognitive function of elderly male patients with vascular dementia.3. To investigate cognitive function and serum E2levels in elderly male patients with vascular dementia with Huperzine A.Methods1. According to the NINDS-AIREN diagnostic criteria,98cases of patients with vascular dementia (VD group) is the object of study, patients with cerebrovascular disease without cognitive impairment (cerebrovascular disease group) and healthy older adults (normal group) are both60cases as a control. 2. Dementia group were randomly divided into the VD study group and the VD control group,49case in the study group on the basis therapy plus Huperzine A(150μg, twice daily), taking three consecutive months; the VD control group given only basis treatment taking three months.3. Using Mini-Mental State Examination MMSE, Chaturvedi Keypiont4channel evoked potentials to measure MMSE score, event-related potentials P300latency and amplitude to the research object before treatment and after three months of treatment.4. Automatic electrochemiluminescence immunoassay system was used to measure serum E2level before treatment in each group and after three months of treatment in the VD group.5. All data are disposed by SPSS16.0statistical package. Using x2test to compare the degree of cultural differences between groups; Using F test to compare the differences of the E2level, the total score of MMSE, the latency of P300and the amplitude among VD group, cerebrovascular disease group, nomal group. Using t test to compare the differences of the E2level, the total score of MMSE, the latency of P300and the amplitude between VD group. Using Pearson correlational analysis method to analyse the interrelation among the E2level, the total score of MMSE, the latency of P300and the amplitude of VD group before and after treatment. All tests are two-sided tests, and there is statistical significance by P is less than0.05.Results1. The serum E2level of the VD group is higher than the group of cerebrovascular disease and the normal group (F=64.170, P=0.000). The serum E2level of the group of cerebrovascular disease is higher than the normal group (P<0.01).2. The latency of P300in the VD group is longer than the group of cerebrovascular disease and the normal group (F=92.944, P=0.000); The P300amplitude in the VD group is lower than the cerebrovascular disease group and the normal group (F=47.766, P=0.000). In the group of cerebrovascular disease, the P300latency is longer than the normal group (P<0.01), and the amplitude of P300is lower than the normal group (P<0.05), the difference is statistically significant.3. Correlation analysis shows that:in the VD group, serum E2level and MMSE score is a negative correlation (r=-0.432,P=0.000), serum E2level is positively associated with the P300latency (r=0.334, P=0.001); Serum E2level and P300amplitude is not associated (r=-0.194, P=0.055); there is a negative correlation between the P300latency and MMSE score (r=-0.309, P=0.002).4. After3months of treatment, in the VD study group, compared with before the treatment and VD control group, the MMSE scores both increase (t=3.337, P=0.001; r=3.736, P=0.000); the latency of P300is lower than before treatment and the VD control group (t=2.653,P=0.010;t=2.098, P=0.038); the amplitude of P300is not statistically significant difference before and after treatment (P>0.05), and also not statistically significant difference compared with the VD control group three month later (P>0.05); in the VD control group, there is no statistical significance about the latency of P300, MMSE, P300amplitude3months later (P>0.05).5. After three months of treatment, the change of serum E2level is not statistically significant difference in the VD study group (t=1.495, P=0.140), the change of serum estradiol level is not statistically significant difference in the VD control group (t=0.542, P=0.590).6. The VD study group after the treatment, correlation analysis shows that:in the VD study group, the difference of serum E2level and the difference of MMSE score, the difference of P300latency, the difference of P300amplitude are not associated (r=-0.119,0.160,0.227, P=0.417,0.273,0.117); the difference of MMSE score and the difference of P300latency is negatively correlated (r=-0.357, P=0.012).Conclusions1. The serum E2level of Elderly male patients with dementia vascular is significantly higher than patients with cerebrovascular disease without cognitive impairment, healthy elderly adults. Higher serum E2level may have certain adverse effects to cognitive function of elderly male patients with vascular dementia.2. Huperzine A can improve cognitive function of elderly male patients with dementia vascular, Huperzine A has no effect on serum E2level of elderly male patients with vascular dementia.