阿托伐他汀联合尼莫地平治疗脑小血管病合并认知功能障碍患者的效果

Effect of Atorvastatin combined with Nimodipine in the treatment of patients with cerebral small vessel disease and cognitive dysfunction

目的探讨阿托伐他汀联合尼莫地平治疗脑小血管病(CSVD)合并认知功能障碍患者的效果。方法选取2020年1月至2022年9月辽宁省金秋医院神经内科收治的92例CSVD合并认知功能障碍患者作为研究对象,按随机数字表法分为观察组(46例)和对照组(46例)。对照组采用尼莫地平进行治疗,观察组在对照组基础上联用阿托伐他汀。比较两组患者的治疗总有效率、不良反应发生率、治疗前后的血清指标和认知功能评分。结果观察组患者的总有效率高于对照组,差异有统计学意义(P<0.05);两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。两组患者治疗后的神经元特异性烯醇化酶(NSE)、血浆同型半胱氨酸(Hcy)水平低于本组治疗前,脑源性神经生长因子(BDNF)水平高于本组治疗前,且观察组患者治疗后的NSE、Hcy水平低于对照组,BDNF水平高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的蒙特利尔认知功能评定量表(MoCA)、简易精神状态评定量表(MMSE)和日常生活能力评定量表(ADL)评分高于本组治疗前,且观察组患者MoCA、MMSE和ADL评分高于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀联合尼莫地平对于CSVD合并认知功能障碍的患者有较好的治疗效果,能减轻神经功能障碍的程度,促进脑部血液循环。

Objective To explore the effect of Atorvastatin combined with Nimodipine in the treatment of patients with cerebral small vessel disease(CSVD)and cognitive dysfunction.Methods Ninety-two CSVD patients with cognitive dysfunction admitted to the Department of Neurology of Jinqiu Hospital in Liaoning Province from January 2020 to September 2022 were selected as the study subjects,they were divided into an observation group(46 cases)and a control group(46 cases)according to the random number table method.The control group was treated with Nimodipine,while the observation group was combined with Atorvastatin on the base of the control group.The total effective rate,incidence of adverse reactions,serum indicators and cognitive function scores before and after treatment in the two groups of patients were compared.Results The total effective rate of the observation group patients was higher than that of the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).After treatment,the levels of neuron specific enolase(NSE)and plasma homocysteine(Hcy)in both groups of patients were lower than those before treatment,the level of brain derived nerve growth factor(BDNF)was higher than that before treatment,the levels of NSE and Hcy after treatment in the observation group were lower than those in the control group,while the level of BDNF was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the scores of the Montreal cognitive function rating scale(MoCA),mini mental state rating scale(MMSE)and daily living ability rating scale(ADL)of the two groups of patients were higher than those before treatment,the MoCA,MMSE,and ADL scores of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion Atorvastatin combined with Nimodipine has a good therapeutic effect on patients with CSVD combined with cognitive dysfunction,reducing the degree of neurological dysfunction and promoting cerebral blood circulation.