西洛他唑与阿司匹林治疗血管性痴呆伴脑白质病疗效比较

Comparison of efficacy of cilostazol and aspirin in the treatment of vascular dementia with white matter lesions

目的：比较西洛他唑与阿司匹林治疗血管性痴呆伴脑白质病的疗效。方法选择血管性痴呆伴脑白质病患者50例，按数字表法随机分为对照组（阿司匹林＋尼莫地平组）和观察组（西洛他唑＋尼莫地平组）。对照组予口服阿司匹林肠溶片＋尼莫地平片，观察组口服西洛他唑片＋尼莫地平片，比较两组治疗后6个月、12个月的认知功能及不良反应发生情况。结果对照组治疗后6个月、12个月，简易智能精神状态检查量表（MMSE）评分、蒙特利尔认知评估量表（MoCA）评分均较治疗前显著提高[治疗前 MMSE 评分、MoCA 评分分别为（20.12±4．25）分、（14．25±4．25）分，治疗后6个月分别为（21．22±4．68）分、（16．45±3.25）分，治疗后12个月分别为（22．38±5．64）分、（16．95±4．68）分；治疗后6个月 MMSE 评分、MoCA 评分与治疗前比较，t ＝0．87、2．06，治疗后12个月 MMSE 评分、MoCA 评分与治疗前比较，t ＝1．96、2．14，均 P ＜0.05]。观察组治疗后6个月、12个月，MMSE 评分、MoCA 评分均较治疗前显著改善[治疗前 MMSE 评分、MoCA 评分分别为（19．85±5．14）分、（13．98±6．28）分，治疗后6个月分别为（23．76±4．15）分、（18．75±4.28）分，治疗后12个月分别为（25．26±3．72）分、（23．95±5．43）分；治疗后6个月 MMSE 评分、MoCA 评分与治疗前比较，t ＝2．96、3．14，治疗后12个月 MMSE 评分、MoCA 评分与治疗前比较，t ＝4．26、6．00，均 P ＜0.05]。两组治疗后6个月、12个月 MMSE 评分差异均有统计学意义（t ＝2．03、2．13，均 P ＜0．05），两组治疗后6个月、12个月 MoCA 评分差异均有统计学意义（t ＝2．14、4．88，均 P ＜0．05）。观察组脑出血发生率为0.00％，对照组为12．00％，两组差异有统计学意义（χ2＝3．19，P ＜0．05）。结论西洛他唑联合尼莫地平治疗血管性痴呆伴脑白质病，能显著改善患者的认知功能，且脑出血发生率低，临床疗效显著，安全性好。

Objective To compare the efficacy of cilostazol and aspirin in the treatment of vascular dementia with white matter lesions.Methods 50 patients with vascular dementia with white matter lesions were randomly divided into control group （aspirin and nimodipine group）and observation group （cilostazol and nimodipine group）. The control group was orally given aspirin enteric -coated tablets and nimodipine tablets,the observation group was treated with cilostazol tablets and nimodipine tablets.Then,the patients were followed up,compared the cognitive function and adverse events of the two groups after treatment 6 months and 1 2 months.Results 6 months and 1 2 months after treatment,MMSE score and MoCA score of the control group were significantly improved[the MMSE score and MoCA score before treatment were （20.1 2 ±4.25）points,（1 4.25 ±4.25）points,6 months after treatment were （21 .22 ±4.68）points,（1 6.45 ±3.25）points,1 2 months after treatment were （22.38 ±5.64）,（1 6.95 ± 4.68）;6 months after treatment,t =0.87,2.06;1 2 months after treatment,t =1 .96,2.1 4,all P 〈0.05].6 months and 1 2 months after treatment,MMSE score and MoCA score of the observation group were significantly improved than before treatment [before treatment the MMSE score and MoCA score were （1 9.85 ±5.1 4）points,（1 3.98 ± 6.28）points,6 months after treatment were （23.76 ±4.1 5）points,（1 8.75 ±4.28）points,1 2 months after treatment were （25.26 ±3.72）points,（23.95 ±5.43 ）points,6 months after treatment t =2.96,3.1 4;1 2 months after treatment,t =4.26,6.00,all P 〈0.05].6,1 2 months after treatment,the MMSE score between the two groups had significant difference （t =2.03,2.1 3,all P 〈0.05）,MoCA score between two groups had significant difference（t =2.1 4,4.88,all P 〈0.05）.The incidence rates of cerebral hemorrhage in the observation group and control group were 0.00%,1 2.00%,the difference was significant （χ2 =3.1 9,P 〈0.05）.Conclusion Cilostazol and nimodipine in the treatment of vascular dementia with white matter lesions,can significantly improve cognitive function of patients, and has less cerebral hemorrhage,significantly clinical effect,good security.