甲钴胺联合多奈哌齐治疗脑小血管病合并认知功能障碍患者的效果

The Effect of Mecobalamin Combined with Donepezil in the Treatment of Patients with Cerebral Small Vessel Disease Complicated with Cognitive Impairment

目的观察在脑小血管病合并认知功能障碍患者中联合应用甲钴胺与多奈哌齐治疗的效果。方法选择本院2021年1月—2023年1月收治的88例脑小血管病合并认知功能障碍患者为研究对象,按随机数字表法将其分为对照组和观察组,每组44例。观察组采用甲钴胺联合多奈哌齐治疗,对照组仅采用多奈哌齐治疗,观察两组的临床疗效、简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、血清血管内皮生长因子(VEGF)水平及不良反应发生情况。结果观察组治疗总有效率为86.36%,高于对照组的63.64%,差异有统计学意义(P<0.05)。治疗前,两组的MoCA评分、MMSE评分及血清VEGF水平比较,组间差异无统计学意义(P>0.05)。治疗12周后,观察组的MoCA评分、MMSE评分分别为(23.30±3.14)分、(24.25±3.31)分,均高于对照组的(21.58±3.33)分、(22.35±3.20)分,组间差异有统计学意义(P<0.05)。治疗12周后,观察组的血清VEGF水平为(241.30±60.14)pg/mL,低于对照组的(285.58±61.33)pg/mL,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在脑小血管病合并认知功能障碍患者中,联合应用甲钴胺和多奈哌齐具有良好的临床疗效与用药安全性,并可显著改善患者的认知功能。

Objective Observation of the therapeutic effect of combined use of mecobalamin and donepezil in patients with cerebral small vessel disease complicated with cognitive impairment and its impact on serum vascular endothelial growth factor(VEGF)levels.Methods 88 patients with cerebral small vessel disease combined with cognitive impairment admitted to our hospital from January 2021 to January 2023 were selected as the research subjects,divided into a control group and an observation group using a random number table method,with 44 cases in each group.Observation group treated with mecobalamin combined with donepezil,the control group only received treatment with donepezil,Observation of clinical efficacy,Mini Mental State Examination(MMSE),Montreal Cognitive Assessment Scale(MoCA),serum VEGF levels,and adverse reactions in two groups.Results The total effective rate of the observation group was 86.36%,which was higher than 63.64%of the control group,and the difference between the groups was statistically significant(P<0.05).Comparison of MoCA score,MMSE score,and serum VEGF levels between the two groups before treatment,there was no statistically significant difference between groups(P>0.05).After 12 weeks of treatment,the MoCA score and MMSE score of the observation group were(23.30±3.14)points and(24.25±3.31)points,respectively,higher than(21.58±3.33)points and(22.35±3.30)points of the control group,the differences between groups were statistically significant(P<0.05).After 12 weeks of treatment,the serum VEGF level in the observation group was(241.30±60.14)pg/mL,which was lower than(285.58±61.33)pg/mL of the control group,the difference between groups was statistically significant(P<0.05).Comparison of total incidence rates of adverse reactions between two groups,there was no statistically significant difference between groups(P>0.05).Conclusion In patients with Cerebral small blood vessel disease combined with cognitive dysfunction,the combination of mecobalaminand donepezil has good clinical efficacy and drug safety,and can significantly improve the cognitive function of patients.