他汀类药物治疗非痴呆型血管性认知障碍的临床观察

Clinical observation of statin therapy in treatment of vascular cognitive impairment no dementia

目的观察阿托伐他汀治疗非痴呆型血管性认知障碍患者的疗效。方法将92例非痴呆型血管性认知功能障碍（VCIND）患者随机分为治疗组和对照组，每组46例。对照组给予对症治疗加安慰剂治疗，治疗组除常规治疗外每晚给予阿托伐他汀20mg，疗程为12个月，采用简易智能状态检查量表（MMSE）、蒙特利尔认知评估量表（MOCA）、临床痴呆量表（CDR）进行治疗前后评分。结果与同组治疗前相比，治疗组治疗6个月后MMSE、MoCA和CDR评分分值差异未见统计学意义（P〉0．05）；治疗12个月后MMSE、MoCA和CDR评分分值差异有统计学意义（P〈0．05）。与对照组相比，治疗组治疗6个月后MMSE、MoCA和CDR评分值差异未见统计学意义（P〉0．05），但治疗12个月后MMSE、MoCA和CDR评分值差异有统计学意义（P〈0．05）。两组均未见严重的不良反应。结论阿托伐他汀能改善VCIND患者的认知功能，坚持服用、依从性较好的患者治疗效果明显。

Objective To observe the efficacy of the atorvastatin therapy on vascular cognitive impairment no dementia （VCIND）. Methods Ninety-two patients with VCIND were devided into treat- ment group and control group, with 46 cases in each group. The patients in treatment group received con- ventional therapy and atorvastatin （20 mg/d） , and the patients in control group received conventional therapy and placebo. The duration of treatment was twelve months. The efficacy was evaluated by mini- mental state examination （MMSE）, Montreal cognitive assessment （MoCA） and clinical dementia rating （CDR） before and after treatment. Results There was no significant difference in the score of MMSE, MoCA and CDR in treatment group after six months treatment （ P 〉 0. 05 ）. After treatment for twelve months, the score of MMSE, MoCA and ADL increased significantly in the treatment group, compared with that before treatment（P 〈 0. 01 ）. There was no significant difference in the score of MMSE, MoCA and CDR between the two group after six months treatment （ P 〉 0.05 ）. After treatment for twelve months, the score of MMSE, MoCA and ADL increased significantly between the two group （P 〈 0.01 ）. There was no serious adverse reaction in all two groups. Conclusions Atorvastatin can improve the cog- nitive function in patients with VCIND. The treatment effect is obvious if patients insist on taking atorvas- tatin and have good compliance.