长春西汀治疗脑梗死后认知障碍的临床研究

Clinical study of treatment of cognitive impairment after cerebral infarction with Vinpocetine

目的探讨长春西汀治疗脑梗死后认知障碍的临床疗效。方法随机将86例住院治疗的脑梗死后认知功能障碍患者分为治疗组和对照组各43例。两组患者均参照《中国脑血管病防治指南》方案给予神经内科入院常规治疗,包括降低颅内压、降纤酶、钙离子拮抗剂、抗血小板聚集、活血化淤、维持水电解质平衡、营养支持等治疗。治疗组予以长春西汀注射液30 mg,加入0.9%氯化钠溶液250 mL,静脉滴注,1次/d。对照组予以胞二磷胆碱注射液1.0 g,加入0.9%氯化钠溶液250 mL,静脉滴注,1次/d。两组患者疗程均为连续应用14 d。结果治疗组总有效率为86.05%,对照组总有效率为65.12%,两组总有效率比较差异有统计学意义(P<0.05)。治疗组认知功能简易精神状态评分中时间空间定向力、记忆力、理解行为操作能力及总体评分与对照组比较,治疗组改善均明显优于对照组,差异均有统计学意义(P<0.05)。治疗组MESSS评分及Barthel指数评分与对照组比较差异有统计学意义(P<0.05)。结论在常规治疗基础上加用长春西汀治疗能够改善脑梗死后认知功能障碍,有利于认知功能的改善和患者肢体运动功能和日常生活活动能力的恢复。

Objective To investigate the therapeutic efficacy of Vinpocetine in the treatment of cognitive impairment after cerebral infarction.Methods 86 hospitalized patients with cognitive dysfunction after cerebral infarction were randomly divided into treatment group and control group,with 43 cases in each group.All patients were given routine treatment for inpatients of neurological department in accordance with Chinese Cerebrovascular Disease Initiative Recommendations.Treatment included reducing intracranial pressure,administration of defibrase,calcium antagonists and anti-platelet aggregation,promoting blood circulation and removing blood stasis,maintaining water and electrolyte equilibrium,and giving nutritional support.In addition to that,patients in the treatment group were given intravenous infusion of 30 mg Vinpocetine in 250 mL 0.9% sodium chloride solution once a day.Patients in the control group were given intravenous infusion of 1.0 g Citicoline Injection in 250 mL 0.9% sodium chloride solution once a day.Both groups were treated uninterruptedly for 14 days.Results The total effective rate was 86.05% and 65.12% in the treatment group and control group.Total effective rate of the two groups were statistically significantly different（P 0.05）.Time and space orientation,memory,understanding,behavior and overall operating capacity test results of mental state evaluation were significantly improved in the treatment group compared with the control group（P 0.05）.MESSS score and Barthel index scores of the treatment group were significantly different from those of the control group（P 0.05）.Conclusion Vinpocetine combined with conventional treatment can improve cognitive function after cerebral infarction and is effective for the recovery of limb motor function and activities of daily living.