奥拉西坦与高压氧联合治疗脑梗死恢复期患者认知功能障碍的效果及安全性

Effect and safety of oxiracetam combined with hyperbaric oxygen treatment on cognitive impairment after cerebral infarction

目的探讨奥拉西坦联合高压氧治疗脑梗死恢复期患者认知功能障碍的效果及安全性。方法选取2015至11月至2016年8月上海中冶医院收治的脑梗死恢复期认知功能障碍患者100例作为研究对象。根据随机数字表法将所有患者分为对照组和观察组,每组50例。在常规治疗基础上,对照组采用奥拉西坦胶囊治疗。观察组采用奥拉西坦胶囊联合高压氧治疗。比较2组患者治疗前后的简易智力状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分、Barthel指数、血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)和D-二聚体水平变化以及治疗期间不良反应情况。结果治疗前2组MMSE评分、MoCA评分、Barthel指数、血清Hcy、CRP、D-二聚体水平比较,差异均无统计学意义(均P>0. 05)。治疗后,2组MMSE评分、MoCA评分、Barthel指数均明显高于治疗前,且观察组明显高于对照组[(25. 3±1. 7)分比(23.2±1.8)分、(24.0±1.7)分比(23.0±1.7)分、(59±6)分比(54±7)分](均P<0.01)。治疗后,2组血清Hcy、CRP、D-二聚体水平均明显低于治疗前,且观察组明显低于对照组[(22±3)μmol/L比(25±3)μmol/L、(8±3) mg/L比(10±3) mg/L、(1.2±0. 6) mg/L比(1.7±0.6) mg/L](均P <0. 01)。2组不良反应发生率比较,差异无统计学意义(P=0. 153)。结论奥拉西坦联合高压氧治疗可以有效提高脑梗死恢复期患者认知功能水平和生活活动能力,并且具有较好的安全性。

Objective To analyze the therapeutic effect and safety of oxiracetam combined with hyperbaric oxygen treatment on cognitive impairment after cerebral infarction. Methods A total of 100 patients with post-cerebral infarction cognitive impairment were enrolled from November 2015 to August 2016 in Shanghai MCC Hospital. They were randomly divided into control group and observation group, with 50 cases in each group. The control group took oxiracetam capsules. The observation group was treated with oxiracetam capsules combined with hyperbaric oxygen therapy. Mini-mental State Examination（MMSE）, Montreal Cognitive Assessment（MoCA）, Barthel index were assessed and levels of serum homocysteine（Hcy）, C-reactive protein（CRP） and D-dimer were tested before and after treatment. Adverse reactions were observed during treatment. Results There were no significant differences of MMSE score, MoCA score, Barthel index, serum levels of Hcy, CRP and D-dimer between groups before treatment（P〉0.05）. After treatment, MMSE score, MoCA score and Barthel index significantly increased and the scores in observation group were significantly higher than those in control group[（25.3±1.7） vs （23.2±1.8）, （24.0±1.7） vs （23.0±1.7）, （59±6） vs （54±7）]（P〈0.01）. After treatment, levels of serum Hcy, CRP and D-dimer significantly decreased; the levels in observation group were significantly lower than those in control group[（22±3）μmol/L vs （25±3）μmol/L, （8±3）mg/L vs （10±3）mg/L, （1.2±0.6）mg/L vs （1.7±0.6）mg/L]（P〈0.01）. Incidence of adverse reactions showed no significant difference between groups（P=0.153）. Conclusion Oxiracetam combined with hyperbaric oxygen treatment can effectively improve cognitive function and activity of living in cerebral infarction patients with cognitive impairment.