盐酸多奈哌齐联合丁苯酞对血管性痴呆患者脑血流变化和认知功能及神经电生理的影响

Effects of donepezil hydrochloride combined with butylphthalide on cerebral blood flow,cognitive function and neuroelectrophysiology in patients with vascular dementia

目的 探讨盐酸多奈哌齐或尼莫地平联合丁苯酞对血管性痴呆(VD)患者脑血流变化、认知功能及神经电生理的影响。方法 选取南方医科大学珠江医院2020年5月至2021年12月诊治的102例VD患者作为研究对象,按照随机数字表法分为观察组(予以丁苯酞联合盐酸多奈哌齐)与对照组(予以丁苯酞联合尼莫地平),各51例,对比脑血流变化[平均通过时间(MTT)、脑血流量(CBF)、脑血容量(CBV)]、简易智能精神状态检查量表(MMSE)、临床痴呆程度量表(CDR)、神经电生理指标[P300潜伏期、P300波幅、(δ+θ)/(α+β)比值]。结果 治疗前,两组MTT、CVB、CBF、MMSE评分、CDR评分、P300潜伏期、P300振动、(δ+θ)/(α+β)比值比较,差异无统计学意义(P>0.05);治疗后,观察组的MMSE评分、P300波幅、CVB、CBF高于对照组,而CDR评分、P300潜伏期、(δ+θ)/(α+β)比值、MTT低于对照组(P<0.05)。观察组不良反应总发生率与对照组相比,差异无统计学意义(P>0.05)。结论 丁苯酞联合盐酸多奈哌齐用于治疗VD,疗效较丁苯酞联合尼莫地平明显,能有效改善患者认知功能及脑血流。

Objective To investigate the impacts of donepezil hydrochloride or nimodipine combined with butylphthalide on cerebral blood flow changes,cognitive function and neuroelectrophysiology in patients with vascular dementia(VD).Methods The VD patients treated between May 2020 and December 2021 were selected and divided into observation group(n=51,using butylphthalide with donepezil hydrochloride)and control group(n=51,using butylphthalide with nimodipine).The changes of cerebral blood flow[mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)],mini-mental state examination scale(MMSE),clinical dementia rating(CDR)and neurophysiological indicators[P300 latency,P300 amplitude,(δ+θ)/(α+β)ratio]were observed and compared between two groups.Results Before treatment,there was no significant difference in MTT,CVB,CBF,MMSE score,CDR score,P300 latency,P300 amplitude and(δ+θ)/(α+β)ratio between two groups(P>0.05).After treatment,MMSE scores,P300 amplitude,CVB and CBF in observation group were significantly higher than those in control group(P<0.05),while CDR scores,P300 latency,(δ+θ)/(α+β)ratio and MTT were lower than those in control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion In the treatment of vascular dementia,butylphthalide combined with donepezil hydrochloride is more effective than butylphthalide combined with nimodipine,and can significantly improve the cognitive function and cerebral blood perfusion in the patients.