尼莫地平辅助治疗脑梗死后认知障碍的效果及对认知功能的影响

Effect of Nimodipine in the adjuvant treatment of cognitive impairment after cerebral infarction and its influence on cognitive function

目的探讨尼莫地平辅助治疗脑梗死后认知障碍的效果及对认知功能的影响。方法选取2016年1月～2017年10月我院收治的96例脑梗死后伴有认知障碍患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各48例。对照组患者给予奥拉西坦4 g治疗,1次/d;观察组患者在对照组基础上加用尼莫地平20 mg治疗,3次/d,连续治疗6个月。比较两组患者治疗前后的简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、美国国立卫生研究院卒中量表(NIHSS)评分及血液黏度指标(血浆比黏度、纤维蛋白原、血细胞比容),并比较两组患者的不良反应发生情况。结果两组患者治疗前的MMSE、MoCA、NIHSS评分比较,差异无统计学意义(P>0.05);两组患者治疗后的MMSE、MoCA评分均高于治疗前,NIHSS评分低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的MMSE、MoCA评分分别为(27.38±4.94)、(24.69±4.37)分,均高于对照组的(24.93±4.38)、(21.87±4.12)分,NIHSS评分为(14.13±4.82)分,低于对照组的(19.13±4.69)分,差异有统计学意义(P<0.05)。两组患者治疗前的血液黏度指标比较,差异无统计学意义(P>0.05);两组患者治疗后的血浆比黏度、纤维蛋白原、血细胞比容均低于治疗前,差异有统计学意义(P>0.05);两组患者治疗后的血液黏度指标比较,差异无统计学意义(P>0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论尼莫地平联合奥拉西坦治疗脑梗死后认知障碍效果显著,有助于认知功能恢复,安全可靠,临床值得推广。

Objective To investigate the effect of Nimodipine in the adjuvant treatment of cognitive impairment after cerebral infarction and its influence on cognitive function.Methods A total of 96 patients with cognitive impairment after cerebral infarction admitted to our hospital from January 2016 to October 2017 were divided into the observation group and the control group according to the random number table method,with 48 cases in each group.Patients in the control group were treated with Oxiracetam 4 g,1 time/d,and the observation group was treated with Nimodipine 20 mg,3 times/d for 6 months.The scores of mini-mental state examination(MMSE),Montreal cognitive assessment scale(MoCA),and national institute of health stroke scale(NIHSS)and blood viscosity(plasma specific viscosity,fibrinogen and hematocrit)were compared before and after treatment between the two groups.And adverse reactions of the two groups were compared.Results There were no significant differences in MMSE,MoCA,and NIHSS scores between the two groups before treatment(P>0.05).The scores of MMSE and MoCA after treatment in the two groups were higher than those before treatment,and the NIHSS scores after treatment were lower than before treatment,and the differences were statistically significant(P<0.05).The scores of MMSE and MoCA in the observation group were(27.38±4.94),(24.69±4.37)points respectively,which were higher than those in the control group accounting for(24.93±4.38),(21.87±4.12)points,the score of NIHSS was(14.13±4.82)points,which was lower than that in the control group accounting for(19.13±4.69)points,and the differences were statistically significant(P<0.05).There was no significant difference in blood viscosity between the two groups before treatment(P>0.05).The plasma specific viscosity,fibrinogen and hematocrit after treatment in the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in blood viscosity between the two groups after treatment(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Nimodipine combined with Oxiracetam is effective in the treatment of cognitive impairment after cerebral infarction,which is helpful to the recovery of cognitive function.It is safe and reliable,and worthy of clinical promotion.