盐酸多奈哌齐治疗卒中后认知功能障碍的启动时机的研究

Study on the Initiation Timing of Donepezil Hydrochloride in the Treatment of Post-stroke Cognitive Impairment

目的:观察不同时间启动盐酸多奈哌齐治疗卒中后认知功能障碍(PSCI)的临床疗效。方法:尚未接受认知治疗PSCI患者120例纳入研究,病程<3个月的患者60例纳入早期组,病程3~6个月患者60例纳入晚期组。收集患者基线资料,2组均在原治疗脑梗死药物基础上,加用盐酸多奈哌齐治疗6个月。于治疗前及治疗1、3、6个月后,采用简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)及临床痴呆评定量表(CDR)对患者进行评估,比较治疗效果。结果:2组基线对比,早期组MMSE、MoCA评分显著高于晚期组(P<0.05),CDR量表评级差异无统计学意义(P>0.05)。治疗1、3及6个月后,2组的MMSE评分、MoCA评分、CDR评分均较治疗前好转。治疗1、3及6个月后,早期组MoCA评分总有效率、MMSE评分升高的人数比例均高于晚期组(均P<0.05),早期组组内3月与1月、6月与3月间的MoCA评分总有效率和MMSE评分升高的人数比例增幅均高于晚期组的增幅(均P<0.05);2组CDR评分好转人数及增幅差异无统计学意义(均P>0.05)。结论:早期使用盐酸多奈哌齐对PSCI的疗效优于晚期使用。

Objective:The aim of this study was to observe the initiation timing of donepezil hydrochloride in the treatment of post-stroke cognitive impairment(PSCI).Methods:One-hundred and twenty patients with PSCI were recruited and divided into early treatment group(course<3 months)and late treatment group(course 3~6 months),60 cases per group.All the cases were treated with donepezil hydrochloride for 6 months.The mini-mental state examination(MMSE),montreal cognitive assessment(MoCA)and clinical dementia rating(CDR)were used to scoring patients at beginning of treatment and 1,3 and 6 months after treatment.Re⁃sults:To compare the baselines of two groups,the MMSE and MoCA scores in the early treatment group were significantly higher than those in the late treatment group(P<0.05),and the CDR scores in two groups have no statistical difference(P>0.05).At 1,3 and 6 months after treatment,the MMSE score,MoCA score and CDR score of the two groups were better than those before treatment.The total effective rate of MoCA score,the proportion of people with increased MMSE score in the early treatment group were significantly higher than those in the late treatment group(P<0.05).The proportion of people with decreased CDR score in two groups have no statistical difference(P>0.05).Conclusion:Treat PSCI with donepezil hydrochloride early is better than late.