多奈哌齐治疗卒中后失语的疗效观察

The efficacy of donepezil for post-stroke aphasia： a pilot case control study

目的评价多奈哌齐治疗急性卒中后失语的疗效。方法将60例急性卒中后失语患者分为治疗组和对照组。所有患者接受规范化的脑血管病治疗，治疗组加用盐酸多奈哌齐5mg／d，共12周。采用西部失语成套测验（WAB）评定疗效。结果12周后，两组患者的WAB各亚项及失语指数（AQ）得分均较基线值有显著地提高，但治疗组的AQ改善程度得分比对照组更为显著[（34．14±17．70）分比（20．69±17．26）分，P=0．004]；治疗组在自发言语、听理解、复述和命名各方面的改善程度均大于对照组，达到统计学意义（P〈0．05）；治疗组中有明显临床改善的患者达60％，而对照组仅为26．7％，差异显著（P=0．009）。结论卒中后3个月内失语患者有不同程度的自然恢复，加用多奈哌齐对自发言语、听理解、复述、命名的恢复可能有促进作用。

Objective To evaluate the efficacy of donepezil for post-stroke aphasia. Methods Sixty patients with acute post-stroke aphasia were divided into treatment group and a control group. All patients had been treated for secondary prevention according to the guideline. The treatment group received donepezil hydrochloride （5 mg/d） for 12 weeks. The efficacy of treatment was measured by comparing the changes of scores of Western Aphasia Battery （WAB） between baseline and 12 weeks later. Results Compared with the baseline, the changes of scores of all items of WAB and Aphasia Quotient （AQ） in both group after 12 weeks follow-up were great, however, the change of AQ was significantly greater in donepezil group （34. 14 -± 17.70） than that in control group （20. 69 ± 17.26） （P =0. 004）. The patients in donepezil group also showed significant recovery in spontaneous speech, comprehension, repetition, and naming than those in control group （ P 〈 0. 05 ）. The rate of significant improving in donepezil group was 60. 0% which was significantly greater than that in control group （ 26. 7% ） （ P = 0. 009 ）. Conclusion There are spontaneous recovery of post-stroke aphasia within 3 months. Donepezil may facilitate the recovery in spontaneous speech, comprehension ,repetition, and naming functions.