| Background:With the increasing number of elderly population,our country is in the old society.The management of the elderly with chronic disease become the focus of national medical and health work.Senile disease more and more,including type 2 diabetes mellitus(T2DM)and alzheimer's disease(AD)incidence is rising,and both diseases are common diseases in the elderly,there is no doubt that affected the physical and mental health of the elderly population will lead to more heavy give would need to take care of the elderly and the economic burden of the family.Recent clinical and animal experimental study have been suggesting alzheimer's disease patients have insulin resistance in brain tissue of signs,so the disease is called "type 3 diabetes" again.Both diseases are belongs to the category of elderly chronic diseases,the pathological features and pathogenesis of which is similar.For the treatment of alzheimer's disease have relatively few drugs,and drug treatment effect is poor.Glp-1 analogues have been animal studies have shown that can improve the memory and cognitive function of dementia transgenic animals,but in the practical work related report is very less,its curative effect and the mechanism is still not fully understood.Related research found that glucagon sample peptide 1 receptor(glp-1 r)exists not only in the pancreas cells,and in the central nervous system,kidney,stomach,lung has widely existed in tissues and organs,such as,can now show that glp-1 and its analogues are through the blood-brain barrier,and the corresponding receptors in brain center organization promote restoration of the nerve cell growth,proliferation,and inhibit its death,reduce inflammation reaction and resistance to free radicals.In addition sample glucagon peptide 1 in the improvement of endothelial function,inhibit tissue inflammation,reduce oxidative stress and improve microcirculation function has good effect.Now studies have confirmed that type 2 diabetes with alzheimer's disease pathology physiology pathology physiology change and prevention have close proximity,given the glp-1 analogues in the treatment of diabetes can have the beneficial effects of central nervous system function at the same time,choose the pancreatic glucagon like peptide 1(glp-1)analogue(e.g.,Essex that peptide)intervention in alzheimer's disease has been the concern of the domestic and foreign scholars.Glp-1 in improve cognitive impairment in AD has more theoretical basis,but it is the lack of adequate clinical research evidence,its curative effect and the mechanism is unclear.This paper adopted by glp-1 analogues in the treatment of type 2 diabetes and cognitive function in alzheimer's disease observation(MMSE),living self-care ability(ADL)and blood sugar,blood lipids and other indicators,for Essex that peptide injection treatment of glp-1 analogues,such as AD provide clinical evidence.Purpose:Study of type 2 diabetes and alzheimer's patients after application of Essex that peptide injection treatment,patients with simple intelligence scale for mental state examination(MMSE),daily life activities ability self-care scale(ADL)and the change of blood glucose,blood lipid,etc,to Essex that peptide injection is used to provide clinical support basis of alzheimer's disease.Methods:Collected in the past two years from the old non insulin dependent diabetes and alzheimer's disease cases.History of all cases are systematically collected and specialized medical.Cases in the group were in 2011,the U.S.national institute on aging(NIA)and the alzheimer's association(AA)released by the alzheimer's disease diagnostic criteria(NIA-AA standard)and the American diabetes association(ADA)published in 2015,the diabetes diagnosis standard of medicine.Alzheimer's disease diagnostic criteria:(1)the incidence of aged 40 to 90 years old,after age 65.(2)the cognitive function defects,(1)memory defect,(2)at least one of the following cognitive dysfunction in the field of performance: a.aphasia,disuse,c.b.agnosia,d.perform administrative barriers.(3)alzheimer's disease progression in 6 months above,characteristic for concealed onset,gradually increase,no easing trend.(4)the MMSE scale: illiteracy 17 points or less,primary school 20 points or less,secondary and above 24 points or less.(5)the ADL scale: > 20 points should have varying degrees of decline.(6)cognitive dysfunction is not due to other mental disorders,such as depression,coma,delirium,etc.(7)craniocerebral CT or MRI showed brain atrophy.AD exclusion criteria: eliminate the following diseases caused by dementia:(1)resulting in progressive loss of cognitive function neural system disease,such as cardiovascular system disease,Parkinson's disease,acute or chronic subdural hematoma,brain tumor,etc.(2)can lead to dementia known systemic disease, such as hypothyroidism,vitamins or lack of folic acid,hypocalcemia,neurosyphilis,infections,etc.(3)cognitive impairment caused by drugs.Standard for type 2 diabetes: FPG fasting glucose or greater tendency for 7.0/L,or 2 h after breakfast in the OGTT blood sugar or greater tendency for 11.1/L or random blood glucose or greater tendency for 11.1/L.The exclusion criteria:(1)of diabetes type 1 diabetes.(2)other types of secondary diabetes(adrenal tumor,pituitary adenoma and thyroid disease secondary elevated blood sugar).In selected cases were divided into control group and Essex that peptide injection treatment group.The control for type 2 diabetes and alzheimer's disease by conventional treatment group,the experimental group for type 2 diabetes and alzheimer's patients in the conventional treatment scheme with Essex that peptide injection treatment.Into the set of all cases are perfect before MMSE,ADL scale evaluation index and blood lipid,blood glucose testing.Groups of related treatment to patients 1 year after repeated MMSE,ADL scale evaluation index and blood lipid,blood glucose testing.Results:1.The control group before and after treatment comparison of MMSE score rate was 7.4%,the experimental group before and after treatment comparison of MMSE score rate was 15.6%,the experimental group the MMSE score rate is significantly higher than the control group,reach level effectively.Two groups of patients into the group of 12 months after the MMSE scale score more obvious difference(P < 0.05),Essex that peptide injection well in the conventional treatment group(control group).2.The control group for 12 months after treatment the ADL scale score decreased,compared with before treatment did not see obvious improvement.The experimental treatment ADL scale scores significantly decreased after 12 months,compared with before treatment has improved significantly.Experimental group than the control group after treatment ADL rating scale to drop,the difference was statistically significant(P<0.05).3.Essex the peptide group compared with the conventional treatment group,blood sugar levels after treatment and glycosylation hemoglobin value was significantly reduced the;Comparing the two groups after treatment,the experimental group blood glucose levels,hemoglobin glycosylation numerical also significantly lower than the control group,the difference was statistically significant(P<0.05).4.Two groups of patients during treatment are routinely taking statins,Essex the peptide group TC,TG,LDL after treatment was decreased significantly,the higher hd L-C;The experimental group after treatment compared with control group after treatment, total cholesterol,triglycerides,low density lipoprotein cholesterol(hdl-c)were significantly decreased,hd L-C increases,the difference was statistically significant(P < 0.05).5.Two groups of patients have the same risk of adverse reactions,no significant statistical difference.Conclusion:1.Essex that peptide injection potential brain nerve protective effect,can significantly improve or delay type 2 diabetes and alzheimer's disease memory and cognitive problems,provide the basis for clinical application in the AD.2.The glp-1 analogues in heart cerebrovascular risk factors play a positive role of blood sugar,blood lipid regulation,Delay the occurrence and development of the disease of heart head blood-vessel.3.The glp-1 analogues treatment group has no adverse reactions such as severe hypoglycemia,suggests that this medicine has good Security. |
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