己酮可可碱治疗非痴呆型脑小血管病的疗效及对局部脑血流的影响

Efficacy of pentoxifylline in the treatment of non-dementia cerebrovascular disease and its effect on regional cerebral blood flow

目的:探讨己酮可可碱(PTX)治疗非痴呆型脑小血管病(CSVD)的疗效及对局部脑血流的影响。方法:选取72例非痴呆型CSVD患者为研究对象,按照治疗方法不同分为对照组和观察组,每组各36例。对照组给予常规治疗,观察组在常规治疗的基础上给予己酮可可碱缓释片治疗,疗程均为24周。比较两组患者日常生活能力、神经功能缺损程度(NFDS)评分、认知功能(ADL)评分及不良反应;采用脉冲式动脉自旋标记灌注磁共振技术检测大脑双侧额叶、颞叶等部位最大相对脑血流量(rCBF)。结果:治疗后,观察组NFDS评分低于对照组(P<0.05);ADL评分、简易智能精神状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分及左右侧颞叶、额叶、顶叶、枕叶、基底节的rCBF高于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:PTX治疗非痴呆型CSVD患者可进一步促进患者认知功能的改善,提高疗效,机制可能与其增加患者大脑各区域脑血流量,提高抗氧化能力有关。

Objective:To evaluate the efficacy of pentoxifylline(PTX)in the treatment of non-dementia cerebrovascular disease(CSVD)and its effect on regional cerebral blood flow.Methods:72 cases of CSVD patients were selected prospectively as the research objects and divided into control group and bservation group according to different treatment method,36 cases in each group.The control group was given conventional treatment,and the observation group was given pentoxacin on the basis of conventional treatment Alkali sustained-release tablets treatment,the course of treatment was 24 weeks.The activities of daily living,neurological deficit(NFDS)score,cognitive function(ADL)score and adverse reactions were compared between the two groups,the pulse arterial spin-labeled perfusion magnetic resonance technique was used to detect the bilateral frontal and temporal lobes of the brain maximum relative cerebral blood flow(rCBF).Results:After treatment,the NFDS score of the observation group was lower than that of the control group,and the ADL score,Mini Mental State Scale(MMSE),Montreal Cognitive Assessment Scale(MoCA),rCBF of the left and right temporal lobe,frontal lobe,parietal lobe,occipital lobe,and basal ganglia were all higher than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:PTX treatment of non-dementia CSVD patients can further promote the improvement of patients cognitive function and improve the efficacy.The mechanism of action may be achieved by increasing the cerebral blood flow in various areas of the patient s brain and improving the antioxidant capacity.