吡拉西坦治疗脑梗塞后血管性痴呆的临床研究

Clinical study of piracetam in the treatment of vascular dementia after cerebral infarction

目的观察吡拉西坦配合高压氧治疗脑梗塞后血管性痴呆的临床效果。方法将69例患者依据治疗方法分为对照组35例与试验组34例。对照组给予高压氧+多奈哌齐+尼莫地平:调节高压氧舱压力至0.2 mPa,加压15 min,压力稳定后患者吸氧20 min,之后吸压缩空气10 min,再次吸氧20 min,之后减压15 min,qd;盐酸多奈哌齐片,每次5 mg,tid,口服;尼莫地平片,每次30 mg,tid,口服。试验组予以高压氧+多奈哌齐+尼莫地平+吡拉西坦:高压氧、多奈哌齐、尼莫地平使用方法同对照组;吡拉西坦片,每次0.8g,tid,口服。2组的临床疗效观察时间设定为90 d。对比2组的评分指标、血清学指标、治疗效果、药物不良反应。结果治疗后,试验组和对照组的简易智力状态检查(MMSE)分别为(23.37±2.24)和(19.78±2.03)分;日常生活能力量表(ADL)分别为(53.68±5.63)和(47.32±4.58)分;临床痴呆评定量表(CDR)分别为(0.90±0.18)和(1.27±0.21)分;白细胞介素(IL)-6分别为(0.41±0.07)和(0.50±0.10)ng·L^(-1);IL-18分别为(35.67±4.03)和(48.53±4.50)pg·mL^(-1),差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组的总有效率分别为94.14%(32例/34例)和74.29%(26例/35例),差异有统计学意义(P<0.05)。试验组和对照组的药物不良反应发生率分别为8.82%(3例/34例)和5.71%(2例/35例),差异无统计学意义(P>0.05)。结论针对脑梗塞后血管性痴呆的患者,使用吡拉西坦配合以高压氧为核心的综合治疗策略,有助于患者的神经功能、生活质量的改善,可提升治疗效果,用药的安全性良好。

Objective To observe the clinical effect of piracetam combined with hyperbaric oxygen in the treatment of vascular dementia after cerebral infarction.Methods According to the treatment method,69 patients were assigned to the control group(35 cases)and assigned to the treatment group(34 cases).The control group was given hyperbaric oxygen+donepezil+nimodipine:Adjust the pressure of the hyperbaric oxygen chamber to 0.2 mPa,pressurize for 15 minutes,after the pressure stabilizes,the patient inhales oxygen for 20 minutes,then inhales compressed air for 10 minutes,inhales oxygen again for 20 minutes,and then decompresses for 15 minutes,qd;Donepezil hydrochloride tablets,5 mg each time,tid,orally;Nimodipine tablets,30 mg each time,tid,orally.The treatment group received hyperbaric oxygen+donepezil+nimodipine+piracetam:The use of hyperbaric oxygen,donepezil and nimodipine was the same as the control group;Piracetam tablets,0.8 g each time,tid,orally.The curative effect observation time of the two groups was set to 90 days.Compare the scoring indexes,serological indexes,treatment effects,and adverse reactions of the two groups.Results After treatment,the simple mental status exa mination(MMSE)of the treatment group and the control group were(23.37±2.24)and(19.78±2.03)points;and the daily living ability scale(ADL)were(53.68±5.63)and(47.32±4.58)points;the clinical dementia rating scale(CDR)were(0.90±0.18)and(1.27±0.21)points;interleukin(IL)-6 was(0.41±0.07)and(0.50±0.10)ng·L^(-1);IL-18 were(35.67±4.03)and(48.53±4.50)pg·mL-1,with significant difference(all P<0.05).After treatment,the total effective rates of the treatment group and the control group were 94.14%(32 cases/34 cases)and 74.29%(26 cases/35 cases),with statistically significant difference(P<0.05).The adverse drug reactions of the treatment group and the control group were 8.82%(3 cases/34 cases)and 5.71%(2 cases/35 cases),with no statistically significant difference(P>0.05).Conclusion For patients with vascular dementia after cerebral infarction,the use of piracetam combined with a comprehensive treatment strategy with hyperbaric oxygen as the core can help improve the patient’s neurological function and quality of life,improve the treatment effect,and have good drug safety.