阿托伐他汀联合尼莫地平治疗轻度脑小血管病性认知功能损害疗效观察

Therapeutic effect of atorvastatin plus nimodipine on mild cognitive impairment in patients with cerebral small vessel disease

目的观察阿托伐他汀联合尼莫地平治疗轻度脑小血管病性认知功能损害的临床疗效和安全性。方法 88例轻度脑小血管性认知功能损害患者,依据治疗方法分为观察组和对照组各44例,观察组给予阿托伐他汀联合尼莫地平治疗,对照组给予尼莫地平治疗,2组疗程均为6个月。比较2组疗效及不良反应发生率,测定治疗前、后总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)水平,观察蒙特利尔评估量表(Montreal Cognitive Assessment,MoCA)、日常生活能力量表(activities of daily living,ADL)评分变化。结果观察组总有效率(95.45%)高于对照组(72.73%)(P<0.01),不良反应发生率(9.09%)与对照组(4.55%)比较差异无统计学意义(P>0.05);观察组治疗后TC、TG、LDL-C水平((4.71±0.88)、(1.97±0.40)、(2.37±0.47)mmol/L)较治疗前((5.80±0.95)、(2.58±0.62)、(3.36±0.76)mmol/L)降低(P<0.01),并低于对照组治疗后TC、TG、LDL-C水平((5.49±0.83)、(2.42±0.49)、(3.22±0.63)mmol/L)(P<0.01);观察组治疗后MoCA、ADL评分(21.70±3.73、67.39±10.03)较对照组(19.73±2.83、62.16±9.55)明显增高(P<0.05)。结论阿托伐他汀联合尼莫地平治疗轻度脑小血管病性认知功能损害效果满意,且不良反应轻。

Objective To investigate the therapeutic effect of atorvastatin plus nimodipine on mild cognitive impairment in patients with cerebral small vessel disease. Methods Eighty-eight patients with cerebral small vessel were divided into two groups according to different treatment methods, with 44 patients in each group. Observation group was treated with atorvastatin plus nimodipine, and control group was treated with nimodipine, for 6 months as one course. The therapeutic effect, the adverse reaction, the levels of total cholesterol （TC）, triacylglycerol （TG）, low density lipoprotein-cholesterol （LDL-C） and high density lipoprotein-cholesterol （HDL-C） were compared between two groups. The changes of Montreal Cognitive Assessment （MoCA） scores and activities of daily living （ADL） were observed. Results The total effective rate was 95.45%in observation group, significantly higher than that in control group （72.73%） （P〈0.01）, and there was no significant difference in the incidence of adverse reaction between two groups （9.09%, 4.55%） （P〉 0.05）. The levels of TC, TG and LDL-C decreased after treatment （（4. 71± 0. 88）, （1. 97± 0.40）, （2. 37±0.47） mmol/L） in comparison with those before treatment （（5. 80±0. 95）, （2. 58±0. 62）, （3. 36±0. 76） mmol/L） in observation group （P〈0.01）, and lower than those in control group after treatment （（5.49 ± 0.83）, （2.42 ± 0.49）, （3.22±0.63） mmol/L） （P〈0.01）. The scores of MoCA and ADL were higher after treatment in observation group （21.70±3.73, 67.39± 10.03） than those in control group （19. 73±2.83, 62. 16±9. 55） （P〈0.05）. Conclusion Atorvastatin plus nimodipine can achieve a satisfactory effect on mild cognitive impairment in patients with cerebral small vessel disease, with mild adverse reaction.