多奈哌齐联合阿托伐他汀治疗老年血管性认知功能障碍疗效评价

Efficacy Evaluation on Donepezil Combined with Atorvastatin for Senile Patients with Vascular Cognitive Impairment

目的评价多奈哌齐联合阿托伐他汀对老年血管性认知功能障碍(VCI)患者的临床疗效。方法将69例确诊VCI的老年患者随机分为多奈哌齐联合阿托伐他汀组(治疗组,35例)和多奈哌齐组(对照组,34例),2组接受常规药物治疗。2组患者于始疗前、治疗第12和24周分别行经颅多普勒(TCD)检查颅内主要动脉的搏动指数(PI)、阻力指数(RI),并进行简易精神状态检查量表(Mini-Mental State Examination,MMSE)和日常生活能力量表(ADL)评分,再进行统计分析。结果治疗第12周治疗组和对照组MMSE评分与治疗前比较,差异均有统计学意义(P<0.01、P<0.05);2组间MMSE评分比较,差异无统计学意义(P>0.05)。治疗第24周治疗组和对照组MMSE评分与治疗前比较,差异均有统计学意义(P<0.01、P<0.01);2组间MMSE评分比较,差异有统计学意义P<0.05)。治疗第12周治疗组和对照组ADL评分与治疗前比较,差异均有统计学意义(P<0.05、P<0.05);2组间ADL评分比较,差异无统计学意义(P>0.05)。治疗第24周治疗组与对照组ADL评分与治疗前比较,差异均有统计学意义(P<0.01、P<0.05);2组间ADL评分比较,差异有统计学意义(P<0.01)。治疗第12周治疗组脑动脉PI值与对照组比较,差异均无统计学意义(P>0.05);治疗第24周治疗组各脑动脉PI值与治疗前及第24周对照组PI值比较,差异均有统计学意义(P<0.05)。治疗12周后治疗组脑动脉RI值与对照组比较,差异无统计学意义(P>0.05);治疗24周后治疗组各脑动脉RI值与治疗前及第24周对照组比较,差异均有统计学意义(P<0.05、P<0.05)。结论多奈哌齐能改善VCI患者的认知功能;多奈哌齐联合阿托伐他汀能更好地改善VCI患者的认知功能,提高生活质量。

[Objective]To evaluate the clinical efficacy of donepezil combined with atorvastatin for senile patients with vascular cognitive impairment（VCI）.[Methods]69 senile patients who were diagnosed with VCI were randomly divided into the donepezil combined with atorvastatin group（the treatment group,35 cases） and the donepezil group（the control group,34 cases）,both two groups received the routine medication.Before treatment,12th week and 24th week of treatment,patients of two groups were tested for the pulsatility index（PI） and resistance index（RI） of major intracranial artery by transcranial Doppler（TCD）,the scores of mini-mental state examination（MMSE） and daily living scale（ADL） were evaluated,and the results were statistically analyzed.[Results]There were significant differences in MMSE scores of the treatment group and the control group between before treatment and 12th week of the treatment（P〈0.01,P〈0.05）.The difference between two groups was not significant（P〉0.05）.There were significant differences in MMSE scores of the treatment group and the control group between before treatment and 24th week of the treatment（P〈0.01,P〈0.05）.The difference in MMSE scores between two groups was significant（P〈0.05）.There were significant differences in ADL scores of the treatment group and the control group between before treatment and 12th week of the treatment（P〈0.05,P〈0.05）.The difference in ADL scores between two groups was not significant（P〈0.05）.There were significant differences in ADL scores of the treatment group and the control group between before treatment and 24th week of the treatment（P〈0.01,P〈0.05）.The difference in ADL scores between two groups was significant（P〈0.01）.At 12th week of treatment,there was no significant difference in cerebral artery PI values between the treatment group and the control group（P〉0.05,P〉0.05）.At 24th week of treatment,there were significant differences in cerebral artery PI values between the treatment group and the control group,and the difference in PI values of the treatment group between the before treatment and 24th week of the treatment was significant（P〈0.05）.At 12th week of treatment,there was no significant difference in cerebral artery RI values between the treatment group and the control group（P〈0.05）.At 24th week of treatment,there were significant differences in cerebral artery RI values between the treatment group and the control group（P〈0.05）,and the difference in RI values of the treatment group between the before treatment and 24th week of the treatment was significant（P〈0.05）.[Conclusion]Donepezil can improve the cognitive function in patients with VCI.Donepezil combined with atorvastatin can further improve the cognitive function of VCI patients,and enhance patients＇ quality of life.