多奈哌齐联合依达拉奉对脑梗死后血管性痴呆的疗效研究

Curative effect of donepezil combined with edaravone on vascular dementia after cerebral infarction

目的探究多奈哌齐联合依达拉奉对脑梗死(CI)后血管性痴呆(VD)的疗效及其机制。方法将医院神经内科收治的116例CI后VD患者随机分为联合组和对照组,各58例。对照组予以盐酸多奈哌齐治疗,联合组予以盐酸多奈哌齐+依达拉奉治疗。比较两组疗效及其治疗前后认知功能[简易精神状态评价量表(MMSE)、改良长谷川痴呆量表(HDS-R)]及精神行为状态[神经精神问卷(NPI)]和血清S100β蛋白(S100β)、神经元特异性烯醇化酶(NSE)、β淀粉样蛋白(Aβ)水平的变化。结果联合组治疗总有效率(93.10%)高于对照组(79.31%)(P﹤0.05);治疗12 w后,两组MMSE评分、HDS-R评分均较治疗前升高,NPI评分及血清S100β、NSE、Aβ水平均较治疗前降低,且联合组上述指标改善程度高于对照组(P﹤0.05)。结论多奈哌齐联合依达拉奉对CI后VD患者的脑组织有保护作用,不仅能有效改善神经认知功能和精神状态,还能减轻脑组织损伤,提高疗效,促进病情转归。

Objective To explore the curative effects and mechanism of donepezil combined with edaravone on vascular dementia （VD） after cerebral infarction （CI）. Methods A total of 116 patients with VD after CI were randomly divided into a combination group and a control group （n =58, respectively）. The control group was treated with donepezil hydrochloride, and the combination group was treated with donepezil plus edaravone. The changes in the curative effects, the neurocognitive functions ＂ Minimental-State Examination （MMSE） and Hasegawa Dementia Scale Revised （HDS-R）＂, and the mental and behavior states ＂Neuropsychiatric Inventory Questionnaire （NPI-Q）＂, as well as those of serum S100β protein （S100β）,Neuron Specific Enolase （NSE）, and amyloid beta （Aβ）before and after the treatment between the two groups were compared. Results The total effective rate in the combination group （93.10%） was higher than that in the control group （79.31%） （P 〈 0.05）. After 12 W of treatment, the MMSE score and the HDS-R score of the two groups were all higher than those before the treatment. The NPI score and the serum S100β , NSE and Aβ levels were all lower than those before the treatment, and the degree of improvement of the above indexes in the combination group was higher than that in the control group （P 〈 0.05）. Conclusion Donepezil combined with edaravone has protective effect on the brain tissue of patients with VD after CI. It can not only improve the neurocognitive function and mental state, but also reducebrain tissue damage, improve the curative effects and promote the prognosis of the disease.