丁苯酞序贯治疗对血管性痴呆患者侧支循环及认知功能预后的影响

Effect of sequential treatment with butylphthalide on collateral circulation and cognitive function prognosis in patients with vascular dementia

目的探讨丁苯酞序贯治疗对血管性痴呆患者侧支循环及认知功能预后的影响。方法选取2017年1月至2018年10月本院收治的血管性痴呆患者106例,随机分成对照组和观察组,各53例。对照组给予丁苯酞治疗2周,观察组在对照组的基础上给予丁苯酞序贯治疗3个月。3个月后比较两组患者治疗效果,大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)血流速度,美国国立卫生院卒中量表(NHISS)、长谷川痴呆量表(HDS)、日常生活能力量表(ADL)评分及不良反应。结果观察组治疗总有效率为92.45%,显著高于对照组的73.58%(P<0.05)。治疗前两组患者的PCA、ACA、MCA血流速度比较差异无统计学意义;治疗后观察组患者PCA、ACA血流速度低于对照组(P<0.05),MCA高于对照组(P<0.05)。治疗前两组患者NHISS、HDS、ADL评分比较差异无统计学意义;治疗后观察组患者NHISS、HDS评分低于对照组(P<0.05),ADL评分高于对照组(P<0.05);两组患者均无严重不良反应,且两组不良反应发生率比较差异无统计学意义。结论丁苯酞序贯治疗血管性痴呆疗效显著,可改善侧支血流循环,提高患者认知功能及生活能力,安全性高。

Objective To investigate the effect of sequential treatment with butylphthalide on collateral circulation and cognitive function prognosis in patients with vascular dementia.Methods A total of 106 patients with vascular dementia were randomly divided into the control group and the observation group,with 53 cases in each group.The control group was treated with butylphthalide for 2 weeks.The observation group was given sequential treatment with butylphthalide for 3 months.After 3 months,the treatment effects,anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA)blood flow velocity,National Institutes of Health Stroke Scale(NHISS),Hasegawa Dementia Scale(HDS),daily living ability (ADL)scores and adverse reactions of the two groups were compared.Results The effective rate of treatment in the observation(92.45%)was significantly higher than that in the control group(73.58%)(P<0.05).There was no statistically significant difference in the blood flow velocity of PCA,ACA and MCA between the two groups before treatment.The blood flow rates of PCA and ACA in the observation group after treatment was significantly lower than that of the control group(P<0.05),and the MCA was significantly higher than that of the control group(P<0.05).There was no significant difference in NHISS,HDS and ADL scores between the two groups before treatment.The NHISS and HDS scores of the observation group after treatment was significantly lower than that of the control group(P<0.05),and the ADL score was significantly higher than that of the control group(P<0.05);There were no serious adverse reactions in the two groups,and there was no statistically significant difference in the incidence of adverse reactions between the two groups.Conclusion Sequential treatment of butylphthalide has obvious effect on vascular dementia,which can improve the collateral blood circulation,promote the improvement of patients'cognitive function and living ability,and has high safety.