丁苯酞与瑞舒伐他汀结合治疗脑梗死后血管性痴呆疗效及对患者脑血管功能、认知状态及血清D-D、sICAM-1、Hcy水平的调节作用

The Effect of Butylphthalide Combined with Rosuvastatin in the Treatment of Vascular Dementia after Cerebral Infarction and its Regulating Effect on Patients'Cerebrovascular Function,Cognitive Status and Serum D-D,sICAM-1 and Hcy Levels

目的:观察丁苯酞与瑞舒伐他汀结合治疗脑梗死后血管性痴呆(VD)疗效及对患者脑血管功能、认知状态及血清D-二聚体(D-D)、可溶性细胞间黏附分子(sICAM-1)、同型半胱氨酸(Hcy)水平的调节作用。方法:选取80例周口市第一人民医院2021年5月至2022年3月就诊的脑梗死后VD患者,根据就诊序号采用电脑随机数字表法分为两组(研究组40例、参照组40例)。常规治疗基础上,参照组给予瑞舒伐他汀,研究组给予丁苯酞联合瑞舒伐他汀,均治疗2个月。比较两组疗效,不良反应以及治疗前、治疗2个月后简易智能精神状态检查量表(MMSE),临床痴呆程度评定量表(CDR),日常生活活动能力量表(BI),脑血管功能指标[颅脑中动脉搏动指数(PI)、收缩期血流速度(Vs)、平均血流速度(Vm)],血脂指标[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)],血清D-D,sICAM-1,Hcy水平。结果:治疗2个月后,研究组总有效率92.50%较参照组72.50%高(P<0.05)。与参照组相比,研究组治疗2个月后MMSE、BI评分较高,CDR评分较低,颅脑中动脉PI水平较低,Vs、Vm水平较高,HDL-C水平较高,TC、LDL-C、TG与血清D-D、sICAM-1、Hcy水平较低(均P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:应用丁苯酞与瑞舒伐他汀结合治疗脑梗死后VD可降低血清D-D、sICAM-1、Hcy水平,改善脑血管功能与血脂水平,提升认知功能,减轻痴呆症状,疗效显著,且具有安全性。

Objective:To observe the benefits of combined treatment of butylphthalide and rosuvastatin in the treatment of vascular dementia(VD)after cerebral infarction and the effects on patients'cerebrovascular function,cognitive status,serum D-dimer(D-D),and soluble intercellular adhesion regulation of molecular(sICAM-1)and homocysteine(Hcy)levels.Methods:A total of 80 patients with VD after cerebral infarction who were treated in The First People's Hospital of Zhoukou from May 2021 to March 2022 were selected and divided into two groups(40 cases in the study group and 40 cases in the reference group)by computer random number table method according to the treatment number.On the basis of conventional treatment,the control group was given rosuvastatin,and the study group was given butylphthalide combined with rosuvastatin,both for 2 months.The curative effect,adverse reactions,mini-mental state examination(MMSE),clinical dementia rating scale(CDR),activities of daily living(BI),and cerebrovascular function were compared between the two groups before and after 2 months of treatment.Indicators[middle cerebral artery pulsatility index(PI),systolic blood flow velocity(Vs),mean blood flow velocity(Vm)],blood lipid indicators[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),triglyceride(TG)],serum D-D,sICAM-1,hcy levels.Results:After 2 months of treatment,the total effective rate of the study group was 92.50%higher than that of the reference group(72.50%)(P<0.05).Compared with the reference group,the MMSE and BI scores of the study group after 2 months of treatment were higher,and the CDR score was lower(P<0.05);compared with the reference group,the middle cranial artery PI level in the study group was lower after 2 months of treatment,and the Vs and Vm levels were higher(P<0.05);compared with the reference group,the study group treated 2 After one month,the level of HDL-C was higher,and the levels of TC,LDL-C,TG,serum D-D,sICAM-1 and Hcy were lower(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of butylphthalide and rosuvastatin in the treatment of VD after cerebral infarction can reduce serum DD,sICAM-1,and Hcy levels,improve cerebrovascular function and blood lipid levels,enhance cognitive function,and reduce symptoms of dementia.It has a significant effect and has security.