盐酸美金刚对急性一氧化碳中毒迟发性脑病认知功能的疗效

Efficacy of memantine on cognitive dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning

目的探讨盐酸美金刚对急性一氧化碳中毒迟发性脑病(DEACMP)认知功能改善的临床疗效。方法本研究为前瞻性,对2013年1月至2017年1月确诊为DEACMP的53例患者,按照随机数字表法分为治疗组(26例)和对照组(27例)。治疗组在常规治疗基础上加用盐酸美金刚治疗;对照组仅给予常规治疗。采用t检验分析治疗前和治疗后6周、12周及24周简易精神状态量表(MMSE)和日常生活能力量表(ADLs)的评分情况。结果治疗前两组MMSE、ADLs评分比较,差异无统计学意义(t值分别为0.112、0.569,P值均>0.05)。治疗后6周、12周及24周,治疗组MMSE、ADLs评分与治疗前比较均显著改善,差异有统计学意义(t值分别1.933、4.828、7.512,3.732、8.191、11.212;P值均<0.05);对照组MMSE、ADLs评分与治疗前比较均显著改变,差异有统计学意义(t值分别1.397、2.410、3.960;3.080、5.494、8.069,P值均<0.05)。治疗第6周、12周时的两组MMSE评分比较,差异无统计学意义(t值分别为0.123、1.450,P值均>0.05),第24周治疗组MMSE评分高于对照组,差异有统计学意义(t=2.146,P<0.05);第6周时两组ADLs评分比较,差异无统计学意义(t=0.773,P>0.05),第12周、24周时,治疗组ADL评分显著低于对照组,差异有统计学意义(t值分别为2.391、2.833,P值均<0.05)。结论在神经营养、高压氧及常规康复训练的常规基础治疗上,给予盐酸美金刚能够有效地改善DEACMP患者的认知功能障碍。

Objective To explore the clinical effect of memantine hydrochloride on the cognitive function improvement in delayed encephalopathy after carbon monoxide poisoning(DEACMP).Methods Fifty-thirty patients with DEACMP from January 2013 to January 2017 were retrospectively selected and randomly divided into treatment group(26 cases)and control group(27 cases)using the random number table method.The treatment group was treated with memantine hydrochloride in addition to the conventional treatment;the control group was only given conventional treatment.T-test was used to analyze Mini-Mental State Scale(MMSE)scores and activities of daily living scale(ADLs)before treatment and six,twelve,and twenty-four weeks after treatment.Results Before treatment,there was no significant difference in MMSE and ADLs scores between the two groups(t=0.112,0.569;all P>0.05).At six weeks,twelve weeks,and twenty-four weeks after treatment,the MMSE and ADLs scores of the treatment group were significantly improved compared with those before treatment,and the difference was statistically significant(t=1.933,4.828,7.512,3.732,8.191,11.212;all P<0.05);the MMSE and ADLs scores in the control group were significantly changed compared with those before treatment,and the difference was statistically significant(t=1.397,2.410,3.960,3.080,5.494,8.069;all P<0.05).There was no significant difference in the MMSE scores between the two groups at six and twelve weeks of treatment(t=0.123,1.450;all P>0.05).The MMSE scores of the treatment group at twenty-four weeks were higher than those of the control group(t=2.146,P<0.05);there was no significant difference in ADLs scores between the two groups at six weeks(t=0.773,P>0.05).At twelve and twenty-four weeks,the ADL scores in the treatment group were significantly lower than those in the control group(t=2.391,2.833;all P<0.05).Conclusions Memantine hydrochloride can effectively improve the cognitive impairment of DEACMP patients based on the conventional treatment of neurotrophic,hyperbaric oxygen,and routine rehabilitation training.