经颅直流电刺激配合丁苯酞对脑梗死后血管性认知障碍患者的影响

Effects of Transcranial Direct Current Stimulation with Butylphthalide in Patients with Post Celebral Infarction Vascular Cognitive Impairment

目的分析经颅直流电刺激(tDCS)配合丁苯酞对脑梗死后血管性认知障碍(VCI)患者脑干诱发电位及外周血神经递质的影响。方法选取2019年4月至2021年6月鄢陵医院86例脑梗死后血管性认知障碍患者,依据随机数字表法分为两组。常规组(n=43)接受丁苯酞,治疗组(n=43)在常规组基础上配合tDCS,对比两组认知功能[长谷川简易智能量表(HDS-R)、简易精神状态量表(MMSE)]、循环血流速度[大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)]、脑干诱发电位[波Ⅲ波幅、波Ⅴ潜伏期、波Ⅲ潜伏期、波Ⅰ潜伏期]、外周血神经递质[同型半胱氨酸(Hcy)、降钙素基因相关肽(CGRP)、脑源性神经营养因子(BDNF)、热休克蛋白70(HSP70)]、不良反应。结果治疗后两组HDS-R评分、MMSE评分比较,治疗组高于常规组(P<0.05);治疗后与常规组比较,治疗组ACA、PCA血流速度较慢,MCA血流速度较快(P<0.05);治疗后,治疗组波Ⅲ波幅高于常规组,波Ⅴ潜伏期、波Ⅲ潜伏期、波Ⅰ潜伏期短于常规组(P<0.05);治疗后,治疗组CGRP、BDNF高于常规组,Hcy、HSP70低于常规组(P<0.05);治疗过程中,不良反应发生率组间比较差异无统计学意义(P>0.05)。结论tDCS辅助丁苯酞治疗VCI患者效果显著,能调节脑血流灌注,改善脑干诱发电位,恢复患者认知功能。

Objective To analyze the effects of transcranial direct current stimulation(tDCS)with butylphthalide on brainstem evoked potentials and peripheral blood neurotransmitters in patients with vascular cognitive impairment(VCI)after cerebral infarction.Methods A total of 86 patients with vascular cognitive impairment after cerebral infarction in Yanling Hospital from April 2019 to June 2021 were selected and divided into two groups based on the random number table method.The conventional group(n=43)received butylphthalide,and the treatment group(n=43)received tDCS on the basis of the conventional group.The cognitive function[Hasegawa dementia scale revised(HDS-R),mini-mental state examination(MMSE)],circulating blood flow velocity[anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA)],brainstem evoked potentials[waveⅢamplitude,waveⅤlatency,waveⅢlatency,waveⅠlatency],peripheral blood neurotransmitters[homocysteine(Hcy),calcitonin gene-related peptide(CGRP),brain-derived neurotrophic factor(BDNF),heat shock protein 70(HSP70)]and adverse effects were compared.Results After treatment,the HDS-R and MMSE scores in the treatment group were higher than those in the conventional group(P<0.05).After treatment,the ACA and PCA blood flow rate were slower and the MCA blood flow rate was faster in the treatment group compared with the conventional group(P<0.05).After treatment,the waveⅢamplitude in the treatment group was higher than that in the conventional group,and the waveⅤlatency,waveⅢlatency and waveⅠlatency were shorter than those in the conventional group(P<0.05).After treatment,CGRP and BDNF in the treatment group were higher than those in the conventional group,and Hcy and HSP70 were lower than those in the conventional group(P<0.05).During treatment,there was no statistical difference in the incidence of adverse reactions between groups(P>0.05).Conclusion tDCS-assisted butylphthalide is effective in treating patients with VCI,regulating cerebral blood perfusion,improving brainstem evoked potentials,and restoring patients’cognitive function.