阿戈美拉汀对阿尔茨海默症患者的认知功能及炎性因子水平的影响

The Effect of Agomelatine on Cognitive Function and Inflammatory Factor Levels in Alzheimer’s Disease Patients

摘要: 目的：本研究旨在探讨阿戈美拉汀对阿尔茨海默症(AD)患者认知功能及炎性因子水平的影响，并初步分析其可能的作用机制，为AD的临床治疗提供新的理论依据。方法：选择2023年1月至2023年12月在青岛市精神卫生中心接受治疗的AD患者，共40例。通过口服阿戈美拉汀治疗8周，使用蒙特利尔认知评估量表(MoCA)和简易精神状态量表(MMSE)评估治疗前后认知功能变化。同时，测定血清IL-6、IL-8、IL-1β和TNF-α水平，分析炎性因子变化及其与认知功能的关系。结果：治疗后，AD患者的MoCA和MMSE评分显著提高(P < 0.001)，表明认知功能有所改善。治疗前，AD组炎性因子IL-6、IL-8、IL-1β和TNF-α水平显著高于健康组(P < 0.001)，治疗后这些因子水平显著下降(P < 0.001)。炎性因子水平与认知功能呈显著负相关(P < 0.001)，并且随着AD病情的加重，炎性因子水平显著升高。结论：阿戈美拉汀通过改善认知功能并显著降低炎性因子水平，发挥其潜在的神经保护作用。炎性因子的升高与AD患者认知功能的损害密切相关，神经炎症可能是AD认知功能衰退的关键因素。本研究为阿戈美拉汀在阿尔茨海默症中的应用提供了新的理论支持和临床依据。

Abstract: Objective: This study aimed to explore the effects of agomelatine on cognitive function and inflammatory factor levels in patients with Alzheimer’s disease (AD), and preliminarily analyze its potential mechanisms, providing new theoretical support for AD clinical treatment. Methods: Forty AD patients treated at Qingdao Mental Health Center from January to December 2023 were included. After 8 weeks of oral agomelatine treatment, changes in cognitive function before and after treatment were assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Meanwhile, serum levels of IL-6, IL-8, IL-1β, and TNF-α were measured to analyze changes in inflammatory factors and their relationship with cognitive function. Results: After treatment, MoCA and MMSE scores of AD patients significantly improved (P < 0.001), indicating enhanced cognitive function. Before treatment, the levels of inflammatory factors IL-6, IL-8, IL-1β, and TNF-α were significantly higher in the AD group compared to the healthy control group (P < 0.001), and these levels significantly decreased after treatment (P < 0.001). There was a significant negative correlation between inflammatory factors and cognitive function (P < 0.001), with higher inflammatory levels associated with more severe AD. Conclusion: Agomelatine significantly improves cognitive function and reduces inflammatory factor levels, exerting a neuroprotective effect. The elevation of inflammatory factors is closely related to cognitive impairment in AD patients, suggesting that neuroinflammation may be a key driver of cognitive decline in AD. This study provides new theoretical support and clinical evidence for the application of agomelatine in the treatment of Alzheimer’s disease.