胞磷胆碱联合丁苯酞软胶囊治疗脑梗死后血管性痴呆的效果及对心理状态的影响

Effects of Citicoline Combined with Butylphthalide Soft Capsule on Vascular Dementia after Cerebral Infarction and Its Effect on Psychological Status

目的探讨胞磷胆碱联合丁苯酞软胶囊治疗脑梗死后血管性痴呆(VD)临床疗效及对患者相关血清指标、心理状态的影响。方法回顾性分析2018年1月—2019年12月收治的脑梗死后VD患者96例,根据治疗方案分为观察组和对照组,各48例。2组均给予常规治疗,对照组在常规治疗基础上口服胞磷胆碱钠片,观察组在对照组基础上口服丁苯酞软胶囊,连续治疗3个月。观察2组认知功能、痴呆程度,评价临床疗效,并检测血清脑源性神经营养因子(BDNF)、降钙素基因相关肽(CGRP)、同型半胱氨酸(Hcy)水平变化,评估患者心理状态。结果治疗后,2组简易智力状态检查量表(MMSE)评分均高于治疗前,临床痴呆评定量表(CDR)、广泛性焦虑量表(GAD-7)、抑郁自测量表(PHQ-9)评分均低于治疗前,且观察组MMSE评分高于对照组,CDR、GAD-7、PHQ-9评分低于对照组(P<0.05)。观察组总有效率高于对照组(P<0.05)。治疗后,2组血清BDNF、CGRP水平均较治疗前升高、Hcy水平均较治疗前下降,且观察组血清BDNF、CGRP水平高于对照组,Hcy水平低于对照组(P<0.05)。2组均未发生严重不良反应。结论胞磷胆碱联合丁苯酞软胶囊用于脑梗死后VD治疗,可更好改善患者认知功能及痴呆程度,能提高临床疗效,且有利于调节患者血清BDNF、CGRP、Hcy水平,减轻焦虑、抑郁情绪。

Objective To observe the clinical efficacy of Citicoline combined with Butylphthalide soft capsules on vascular dementia(VD)after cerebral infarction and its effects on related serum indexes and psychological status of patients.Methods A retrospective analysis was performed on 96 patients with VD after cerebral infarction admitted from January 2018 to December 2019.According to the treatment regimen,they were divided into the observation group(n=48)and the control group(n=48).Both groups were given conventional treatment.The control group was given Citiloline sodium tablets orally on the basis of conventional treatment,while the observation group was given Butylphthalide soft capsule orally on the basis of the control group,and the treatment lasted for 3 months.The cognitive function and degree of dementia of the 2 groups were observed,and the clinical efficacy was evaluated.The changes of serum levels of brain-derived neurotrophic factor(BDNF),calcitonin gene-related peptide(CGRP)and homocysteine(Hcy)were detected,and the psychological state of the patients was evaluated.Results After treatment,the scores of Mini-Mental State Examination(MMSE)was higher,but clinical Dementia Rating scale(CDR),Generalized Anxiety Scale(GAD-7)and depression Self-assessment Scale(PHQ-9)were lower in the two groups,as compared with those before treatment.MMSE scores in the observation group were higher than those in the control group,and the scores of CDR,GAD-7 and PHQ-9 in the observation group were lower than those in the control group(P<0.05).The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,serum BDNF and CGRP levels in both groups were increased and Hcy levels were decreased compared with those before treatment(P<0.05).Moreover,serum BDNF and CGRP levels in the observation group were higher than those in the control group,and Hcy levels were lower than those in the control group(P<0.05).No serious adverse reactions occurred in the 2 groups.Conclusion Citicoline combined with Butylphthalide soft capsules for VD after cerebral infarction can better improve the cognitive function and dementia degree and can improve clinical efficacy.In addition,it helps to adjust the serum BDNF,CGRP and Hcy levels,and relieve the anxiety and depression.