参附注射液对脑微出血诱发认知功能障碍的缓解作用

Effects of Shenfu Injection on Cognitive Dysfunction Induced by Cerebral Microbleeds

目的:探讨参附注射液对脑微出血(cerebral microbleeds,CMB)诱发认知功能障碍的缓解作用及对血清胱抑素C(Cys C)和谷氨酸(Glu)的影响。方法:选取2016年12月至2018年12月湛江中心人民医院收治的CMB患者100例,以随机数字表法分为观察组和对照组,每组50例。对照组患者给予常规治疗,观察组患者在对照组的基础上加用参附注射液。比较两组患者的病灶数目、认知功能[蒙特利尔认知量表(Montreal cognitive assessment,MoCA)评分]、生活质量[日常生活能力(activities of daily living,ADL)评分及生活质量综合评定问卷(Generic Quality of Life Inventory-74,GQOL-74)评分]、血清CysC和Glu水平的差异。结果:治疗后,对照组患者CMB病灶数较治疗前轻微减少;观察组患者CMB病灶数明显少于治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,对照组患者的MoCA评分轻微升高;观察组患者的MoCA评分明显高于治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,两组患者ADL和GQOL-74评分均较治疗前明显升高,且观察组患者明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清Cys C和Glu水平较治疗前明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。结论:参附注射液可能通过调节CysC和Glu水平而改善CMB患者的出血情况,缓解CMB对认知功能的损伤,提高患者生活质量。

OBJECTIVE: To investigate the relieving effect of Shenfu injection on cognitive dysfunction induced by cerebral microbleeds(CMB), and its effects on cystatin C(Cys C) and glutamate(Glu). METHODS: Totally 100 patients with CMB admitted into Zhanjiang Central People’s Hospital from Dec. 2016 to Dec. 2018 were extracted to be divided into the observation group and the control group via the random number table, with 50 cases in each group. The control group was given conventional treatment, while the observation group received Shenfu injection on the basis of the control group. The number of lesions, cognitive function[Montreal cognitive assessment(MoCA) score], quality of life[activities of daily living(ADL) score, Generic Quality of Life Inventory-74(GQOL-74) score], serum CysC and Glu levels in two groups were compared. RESULTS: After treatment, the number of CMB lesions in the control group was slightly less than that before treatment, the number of CMB lesions of the observation group was significantly less than that before treatment and the control group after treatment, the differences were statistically significant(P<0.05). After treatment, the MoCA score in the control group was slightly higher than that before treatment, the MoCA score of the observation group was significantly higher than that before treatment and the control group after treatment, the differences were statistically significant(P<0.05). After treatment, the ADL score and GQOL-74 score of two groups were significantly higher than those before treatment, and the observation group was significantly higher than the control group, the difference was statistically significant(P<0.05). After treatment, the serum levels of Cys C and Glu in two groups decreased significantly than those before treatment, and the observation group was significantly lower than the control group, with statistically significant differences(P<0.05). CONCLUSIONS: Shenfu injection may improve the bleeding of CMB patients by regulating the levels of CysC and Glu, alleviate the damage of CMB on cognitive function and improve the quality of life.