非痴呆型血管性认知功能障碍患者神经心理学特点及石杉碱甲的临床疗效观察

Research of the Patients with Vascular Cognitive Impairment no Dementia in Terms of Neuropsychology and the Clinical Study of Huperzine A in the Treatment

目的:探讨非痴呆型血管性认知功能障碍(VCIND)患者的神经心理学特点,观察石杉碱甲对认知功能损害的改善作用。方法:将64例VCIND患者随机分成2组:常规治疗组和石杉碱甲治疗组;另设健康对照42例。3组均进行简易智能状态检查量表(MMSE)、画钟试验(CDT)测定。VCIND患者治疗第4和第8周时重新测定MMSE及CDT并加以对比。结果:①VCIND组与健康对照组在CDT评分、MMSE总分以及时间定向、地点定向、计算能力、短程记忆、言语复述、阅读能力、语言表达及图形描绘方面的差异有显著统计学意义(P<0.01)。②石杉碱甲治疗的VCIND患者第8周时MMSE、CDT评分与治疗前及常规治疗组比较均有明显改善。结论:①CDT、MMSE总分及亚项的测评,有利于早期发现VCIND患者的认知功能受损。②石杉碱甲可有效改善VCIND患者的认知功能损害。

Aim： To investigate the characteristics of the patients with vascular cognitive impairment no dementia（VCIND） in terms of neuropsychology and to observe the efficacy of huperzine A in treating VCIND. Methods： 64 patients with VCIND and 42 normal controls were examined with the neuropsychological test, including mini-mental state examination（MMSE）, clock drawing test （CDT）. 64 patients with VCIND were randomly divided into 2 groups： a huperzine A treated group and a control group. The whole course of treatment for each group lasted 8 weeks. MMSE and CDT were examined in the 4th week and 8th week. Results： （1） The scores of CDT and MMSE in the VCIND group were significantly lower than those in the control group（P〈0.01）. The scores of subitems of MMSE including time orientation, place orientation, account ability, short time memory, language repetition, reading comprehension, language expression, figure portrayal in patients with VCIND were lower than those in the normal subjects（all P〈0.01）. （2）After 8 weeks, the marksof MMSE and CDT of huperzine A treated group were more improved than before and the control group. Conclusion： （1） The combination of MMSE and CDT can be used for early finding of cognitve impairment in VCIND patients. （2） Huperzine A can improve the cognitive function of patients with VCIND.