依达拉奉联合丁苯酞治疗对脑梗死后血管性痴呆患者认知功能和神经因子的影响

Effects of edaravone combined with butylphthalide on cognitive function and nerve factors in patients with vascular dementia after cerebral infarction

目的探究依达拉奉联合丁苯酞治疗对脑梗死后血管性痴呆患者认知功能和神经因子的影响。方法采用回顾性研究,2017年1月到2020年12月天津市解放军第九八三医院所接受的脑梗死后血管性痴呆患者90例进行研究,根据治疗方案将其分为对照组、观察组,每组各45例,其中对照组给予丁苯酞治疗,观察组给予丁苯酞、依达拉奉联用1个月,并比较两组疗效、治疗前后脑血流状态指标[大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、左右椎动脉(VA)的血流速度]、神经因子[神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)]水平以及神经功能、精神症状、认知能力评分。结果观察组总有效率为95.56%,高于对照组(77.78%),差异有统计学意义(P<0.05)。治疗后,观察组MCA、VCA、PCA、VA血流速度水平为(33.61±5.25)、(53.58±6.16)、(33.57±3.45)、(33.57±3.45)cm/s,均高于对照组[(24.58±4.42)、(47.42±5.79)、(30.51±3.26)、(29.82±4.57)cm/s],差异均有统计学意义(P<0.05)。治疗后,观察组NGF、BDNF水平为(12.32±1.57)ng/mL、(12.46±1.53)pg/mL,均高于对照组[(9.08±1.13)ng/mL、(9.68±1.25)pg/mL],NSE水平为(47.16±9.22)μmol/L,低于对照组[(81.13±15.36)μmol/L],差异均有统计学意义(P<0.05)。治疗后,观察组NIHSS评分为(8.52±3.39)分,低于对照组[(12.47±3.56)分],MMSE评分、MoCA评分为(23.05±5.21)、(26.01±2.26)分,均高于对照组[(18.03±2.35)、(21.76±2.14)分],差异均有统计学意义(P<0.05)。观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论依达拉奉联合丁苯酞治疗脑梗死后血管性痴呆效果满意,不仅可有效改善患者脑部血流动力学,还能调节神经因子,促进认知功能恢复,且安全性较高,值得推广。

Objective To explore the effects of edaravone combined with butylphthalide on cognitive function and nerve factors in patients with vascular dementia after cerebral infarction and stroke.Methods A retrospective study was conducted on 90 patients with vascular dementia after cerebral infarction accepted by the 983 Hospital of Tianjin People's Liberation Army from January 2017 to December 2020.According to the treatment plan,they were divided into control group and observation group,with 45 cases in each group.The control group was treated with butylphthalide,and the observation group was treated with butylphthalide and edaravone for one month.The effects of the two groups and cerebral blood flow status indicators[blood flow velocity of middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA),left and right vertebral arteries(VA)]and nerve factors[neuron-specific enolase(NSE),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF)]and neurological function,psychiatric symptoms,cognitive ability scores before and after treatment were compared.Results The total effective rate of the observation group was 95.56%,which was higher than that of the control group(77.78%),the difference was statistically significant(P<0.05).After treatment,the blood flow velocity levels of MCA,VCA,PCA,and VA in the observation group were(33.61±5.25),(53.58±6.16),(33.57±3.45),and(33.57±3.45)cm/s,which were higher than those in the control group[(24.58±4.42),(47.42±5.79),(30.51±3.26),(29.82±4.57)cm/s],the differences were statistically significant(P<0.05).After treatment,the levels of NGF and BDNF in the observation group were(12.32±1.57)ng/mL,(12.46±1.53)pg/mL,which were higher than those in the control group[(9.08±1.13)ng/mL,(9.68±1.25)pg/mL],the NSE level was(47.16±9.22)μmol/L,which was lower than that of the control group[(81.13±15.36)μmol/L],and the difference was statistically significant(P<0.05).After treatment,the NIHSS score of the observation group was(8.52±3.39)points,which was lower than that of the control group[(12.47±3.56)points],the MMSE score and MoCA score of the observation group were(23.05±5.21),(26.01±2.26)points,which were higher than those of the control group[(18.03±2.35),(21.76±2.14)points],the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Edaravone combined with butylphthalide has satisfactory effect in the treatment of vascular dementia after cerebral infarction.It can not only effectively improve the brain hemodynamics of patients,but also regulate nerve factors and promote the recovery of cognitive function.It is safe and worthy of promotion.