舍曲林联合尼莫地平对急性缺血性卒中患者血管性认知功能损害的影响

Effect of sertraline on vascular cognitive impairment in patients with acute ischemic stroke

目的探讨舍曲林联合尼莫地平对急性缺血性卒中患者血管性认知功能损害的影响。方法选取2015年11月—2017年11月在佛山市第二人民医院就诊的68例急性缺血性卒中血管性认知功能损害患者,随机分为观察组和对照组,每组各34例。对照组在常规治疗基础上给予患者口服尼莫地平30 mg,3次/d。观察组在对照组基础上给予患者口服舍曲林50 mg,每晚1次。两组均治疗4周。对比两组简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、阿尔茨海默病评定量表认知部分量表(ADAS-cog)、美国国立卫生研究院脑卒中量表(NIHSS)、日常生活能力评定量表(BI指数)评分和不良反应发生情况。结果治疗前两组MMSE评分、MoCA评分、ADAS-cog评分、NIHSS评分和BI指数比较,差异无统计学意义。治疗后两组MMSE评分、MoCA评分和BI指数均显著高于治疗前,ADAS-cog评分和NIHSS评分均显著低于治疗前,同组治疗前后比较差异均有统计学意义(P<0.05);且观察组MMSE评分、MoCA评分和BI指数均显著高于对照组,ADAS-cog评分和NIHSS评分均显著低于对照组,组间差异均有统计学意义(P<0.05)。观察组不良反应发生率8.82%(3/34),与对照组不良反应发生率5.88%(2/34)比较,差异无统计学意义。结论舍曲林联合尼莫地平可有效减轻急性缺血性卒中患者血管性认知功能损害,值得临床推广。

Objective To investigate the effect of sertraline on vascular cognitive impairment(VCI) in patients with acute ischemic stroke.Methods 68 patients with acute ischemic stroke VCI in our hospital from November 2017 to November 2015 were randomly divided into the observation group(nimodipine + sertraline, n = 34) and the control group(nimodipine, n = 34). The MMSE score,MoCA score, ADAS-cog score, NIHSS score, BI index and incidence of adverse reactions were compared between the two groups.Results There was no significant difference in the scores of MMSE, MoCA, ADAS-cog, NIHSS and BI between the two groups before treatment. After treatment, the MMSE score, MoCA score and BI index of the two groups were significantly higher than those before the treatment(P < 0.05), and the ADAS-cog score and the NIHSS score were significantly lower than those before the treatment(P < 0.05), and the MMSE score, MoCA score and BI index in the observation group were significantly higher than those in the control group(P < 0.05), the ADAS-cog score and NIHSS score in the observation group were significantly lower than those in the control group(P < 0.05). The incidence of adverse reactions in the observation group was 8.82%(3/34), and the incidence of adverse reactions in the control group was 5.88%(2/34). There was no significant difference between the two groups.Conclusion Sertraline can effectively improve VCI in patients with acute ischemic stroke, and is worthy of clinical promotion.