大脑中动脉狭窄患者认知功能改变及胞磷胆碱钠片的疗效观察

The change of the cognitive function of the patients with middle cerebral artery stenosis and efficacy of brain citicoline sodium tablets

目的探讨大脑中动脉狭窄患者与认知功能改变之间的关系,并采用胞磷胆碱钠片对患者进行为期12w的正规治疗,以观察其疗效。方法选择大脑中动脉狭窄患者80例,并根据有无脑梗死分为狭窄无梗死组(41例)和狭窄梗死组(39例),另选健康体检者80例为对照组。进行全面的神经心理学测试,包括简易精神状态检查量表(MMSE)、记忆力、执行能力、信息处理速度、注意力及结构能力等检查。同时,对认知功能异常的患者给予胞磷胆碱钠片治疗12w后,再次进行神经心理学测试,比较用药前后患者的认知功能有否变化。结果与对照组比较,狭窄梗死组各项认知功能评分明显降低(P<0.05);狭窄无梗死组MMSE、言语性记忆、视觉性记忆、注意力及结构能力的认知功能评分明显降低(P<0.05)。用药后,狭窄梗死组在言语性记忆中即刻回忆功能、视觉性记忆(Rey-Osterrieth复杂图形测验)中临摹和再认功能、执行能力中的Stroop C测验、结构能力中的积木、画钟测验评分较用药前明显升高(P<0.05);狭窄无梗死组在视觉性记忆中临摹功能、结构能力中的画钟测验评分较用药前明显升高(P<0.05)。结论大脑中动脉狭窄者在脑梗死前或脑梗死后都已经存在不同程度的认知功能损伤,胞磷胆碱钠片可以改善认知功能的损害。

Objective Explore the relationship between middle cerebral artery stenosis and changes in cognitive function, and 12 weeks regular treatment of patients with citicoline sodium tablets, in order to observe its efficacy. Methods Selecting 80 patients with the middle cerebral artery stenosis, divided into 41 cases of stenosis without infarction group and 30 cases of stenosis with infarction group according to the presence of cerebral infarction, and to elect 80 healthy patients as a control group. Performance neuropsychological tests, including the MMSE, memory, ability to execute, information processing speed, attention and the structural capacity checks. Brain protective agent was given to the patients with cognitive dysfunction for 12 weeks, compared changes before and after treatment. Results Compared with the control group, cognitive function score of stenosis infarction group was significantly lower, the difference was statistically significant （P〈0.05）; The MMSE, verbal memory, visual memory, attention, structural capacity, cognitive function score of stenosis without infarction group was significantly lower, the difference was statistically significant （P〈0.05）. After treatment, stenosis infarction group in immediate recall function, copying and recognition function, the building blocks, the clock drawing test score was significantly higher, the difference was statistically significance （P〈0.05） ; stenosis without infarction copying functions, WAIS- RC picture arrangement, the clock drawing test score significantly higher than before treatment, the difference statistically significant （P〈0.05）. Conclusion The patients who with middle cerebral artery stenosis have varying degrees of cognitive impairment wether the patients were with cerebral infarction or without cerebral infarction, cerebral protective agent can improve cognitive function damage.