丁苯酞软胶囊对脑梗死后轻度认知功能障碍患者脑血流灌注和认知功能的影响

Effect of butylphthalide soft capsule on cerebral blood perfusion and cognitive function in patients with mild cognitive impairment after cerebral infarction

目的探讨丁苯酞软胶囊对脑梗死后轻度认知功能障碍患者脑血流灌注和认知功能的影响。方法选取90例脑梗死后轻度认知功能障碍患者作为研究对象,采用随机数表法将其分为对照组和观察组,每组45例。对照组采用抗血小板聚集、改善微循环等常规治疗,观察组在对照组基础上给予丁苯酞软胶囊口服治疗,连续治疗2周。比较2组治疗前后脑血流灌注指标[脑血流量(CBF)、脑血容量(CBV)和平均通过时间(MTT)]、血清学指标[神经元特异性烯醇化酶(NSE)、同型半胱氨酸(Hcy)和脑活性肽100-β(S-100β)]水平及认知功能[蒙特利尔认知评估量表(MoCA)和简易智力状态检查量表(MMSE)评分]情况。结果治疗后,2组CBF、CBV水平高于治疗前,MTT短于治疗前,且观察组CBF、CBV水平高于对照组,MTT短于对照组,差异均有统计学意义(P<0.05);治疗后,2组血清NSE、Hcy和S-100β水平低于治疗前,且观察组血清NSE、Hcy和S-100β水平低于对照组,差异均有统计学意义(P<0.05);治疗后,2组MoCA评分和MMSE评分高于治疗前,且观察组MoCA评分和MMSE评分高于对照组,差异均有统计学意义(P<0.05)。结论丁苯酞软胶囊可改善脑梗死后轻度认知功能障碍患者的脑组织血流灌注情况,降低血清NSE、Hcy及S-100β水平,促进认知功能恢复。

Objective To explore the effect of butylphthalide soft capsule on cerebral blood perfusion and cognitive function in patients with mild cognitive impairment after cerebral infarction.Methods A total of 90 patients with mild cognitive dysfunction after cerebral infarction were selected and randomly divided into control group and observation group,with 45 cases in each group.The control group was treated with conventional therapies such as anti-platelet aggregation and microcirculation improvement therapies,while the observation group was treated with butylphthalide soft capsules on the basis of the control group.The treatments of two groups were lasted for 2 weeks.Before and after treatment,the levels of cerebral blood perfusion indexes[cerebral blood flow(CBF),cerebral blood volume(CBV)and mean transit time(MTT)],serological indexes[neuron specific enolase(NSE),homocysteine(Hcy)and cerebral active peptide 100-β(S-100β)]and cognitive functions[Montreal Cognitive Assessment Scale(MoCA)and Mini Mental State Examination(MMSE)]were compared between the two groups.Results After treatment,the CBF and CBV levels in both groups were significantly higher than those before treatment,while MTT was significantly shorter than that before treatment,and the CBF and CBV levels of the observation group were significantly higher than those of the control group,and the MTT was significantly shorter than that of the control group(P<0.05).After treatment,the levels of NSE,Hcy and S-100βin both groups were significantly lower than those before treatment,and the levels of NSE,Hcy and S-100βin the observation group were significantly lower than those in the control group(P<0.05).After treatment,the MoCA score and the MMSE score in both groups were significantly higher than those before treatment,and the scores of the MoCA and the MMSE in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Butylphthalide soft capsule can improve the cerebral blood perfusion of patients with mild cognitive impairment after cerebral infarction,reduce the levels of serum NSE,Hcy and S-100β,and promote the recovery of cognitive function.