丁苯酞联合依达拉奉治疗老年血管性痴呆的临床分析

Clinical analysis of butylphthalide combined with edaravone in treatment of senile vascular dementia

目的观察丁苯酞联合依达拉奉治疗老年血管性痴呆(VD)的临床效果,为治疗老年VD提供方法。方法选择2019年6月-2020年4月于北部战区空军医院接受治疗的例老年VD患者126例,依据随机数字表法分为观察组(n=63)和对照组(n=63)。对照组予以依达拉奉静脉注射治疗,观察组予以丁苯酞联合依达拉奉静脉注射治疗。观察并比较2组治疗前后血清中氧化应激指标[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、丙二醛(MDA)]和血管内皮功能指标[血浆内皮素(ET-1)、一氧化氮(NO)、血管内皮生长因子(VEGF)]变化;观察并比较2组痴呆程度量表(CDR)评分和日常生活活动能力量表(ADL)评分;评估并比较2组临床疗效和不良反应情况。结果治疗后,2组血清SOD、CAT、NO与VEGF水平均明显高于同组治疗前(P<0.05),且观察组血清SOD、CAT、NO与VEGF水平均显著高于对照组(P<0.05);2组MDA和ET-1水平均明显低于同组治疗前(P<0.05),且观察组血清MDA和ET-1水平显著低于对照组(P<0.05);2组ADL评分均提高,且观察组较对照组更高(P<0.05);2组CDR评分均明显低于同组治疗前(P<0.05),且观察组CDR评分明显低于对照组(P<0.05)。观察组总有效率显著高于对照组(P<0.05)。2组不良反应差异无统计学意义(P>0.05)。结论丁苯酞联合依达拉奉治疗能明显改善老年VD患者的氧化应激和血管内皮功能,有利于促进患者日常生活能力和认知功能恢复,且安全可靠,具有一定的临床应用价值。

Objective To explore the clinical effect of butylphthalide combined with edaravone in the treatment of senile vascular dementia(VD)and provide methods for the treatment of VD in the elderly.Methods A total of 126 elderly VD patients who were treated in the Northern Theater Air Force Hospital from June 2019 to April 2020 were selected and di-vided into observation group(n=63)and control group(n=63)according to the random number table method.The control group was treated with edaravone intravenous injection,and the observation group was treated with butylphthalide combined with edaravone intravenous injection.The levels of serum oxidative stress indexes[superoxide dismutase(SOD),catalase(CAT),malondialdehyde(MDA)]and vascular endothelial function indexes[plasma endothelin-1(ET-1),nitric oxide(NO)and vascular endothelial growth factor(VEGF)],the scores of Clinical Dementia Scale(CDR)and activity of daily living(ADL)scale were observed and compared between the two groups before and after treatment.The clinical efficacy and adverse reactions of the two groups were evaluated and compared.Results After treatment,the levels of serum SOD,CAT,NO and VEGF of the two groups were significantly higher than those of the same group before treatment(P<0.05),and the levels of above indexes of the observation group were significantly higher than those of the control group(P<0.05);the levels of serum MDA and ET-1 of the two groups were significantly lower than those of the same group before treatment(P<0.05),and the levels of above indexes of the observation group were significantly lower than those of the control group(P<0.05);the ADL score of the two groups increased,and the ADL score of the observation group were higher than that of the control group(P<0.05);the CDR scores of the two groups were significantly lower than those of the same group before treatment(P<0.05),and the CDR score of the observation group were significantly lower than that of the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Butylphthalide com-bined with edaravone can significantly improve the oxidative stress and vascular endothelial function of elderly VD patients,promote the recovery of daily living ability and cognitive function,and is safe and reliable.It has a certain clinical value.