谷红注射液联合艾地苯醌治疗脑梗死后血管性痴呆的效果及对患者认知功能和血液流变学的影响

Effect of Guhong injection combined with idibenone in the treatment of vascular dementia after cerebral infarction and its influence on cognitive function and hemorheology

目的探究谷红注射液联合艾地苯醌治疗脑梗死后血管性痴呆(VaD)的效果及对患者认知功能和血液流变学的影响。方法78例脑梗死后VaD患者,采用随机数字表法分为观察组(39例)和对照组(39例)。对照组接受艾地苯醌治疗,观察组接受谷红注射液联合艾地苯醌治疗。比较两组临床疗效、认知功能[蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)评分]、血液流变学(血浆粘度、全血高切粘度、全血低切粘度、纤维蛋白原)、脑动脉[大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)]血流速度、不良反应发生情况。结果观察组临床总有效率97.44%显著高于对照组的84.62%(P<0.05)。治疗后,两组MoCA、MMSE评分显著高于治疗前,且观察组MoCA评分(25.67±1.08)分、MMSE评分(25.98±1.65)分显著高于对照组的(21.69±1.39)、(22.39±1.94)分(P<0.05)。治疗后,两组血浆粘度、全血高切粘度、全血低切粘度、纤维蛋白原均显著低于治疗前,且观察组血浆粘度(1.53±0.37)mPa·s、全血高切粘度(4.98±0.64)mPa·s、全血低切粘度(6.98±1.26)mPa·s、纤维蛋白原(2.18±0.49)g/L均显著低于对照组的(2.16±0.42)mPa·s、(7.26±0.75)mPa·s、(8.26±1.38)mPa·s、(3.08±0.73)g/L(P<0.05)。治疗后,两组ACA、MCA、PCA血流速度均显著高于治疗前,且观察组ACA、MCA、PCA血流速度分别为(46.89±3.15)、(53.17±4.17)、(41.28±3.61)cm/s,均显著高于对照组的(43.94±3.77)、(50.26±3.58)、(38.15±3.57)cm/s(P<0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。结论脑梗死后Va D患者接受谷红注射液联合艾地苯醌治疗较单药艾地苯醌治疗临床效果更显著,对认知功能、血液流变学以及脑动脉血流速度改善显著,且安全性良好。

Objective To explore the effect of Guhong injection combined with idibenone in the treatment of vascular dementia(VaD)after cerebral infarction and its influence on cognitive function and hemorheology.Methods 78 patients with VaD after cerebral infarction were divided into an observation group(39 cases)and a control group(39 cases)by random numerical table method.The control group was treated with idebenone,and the observation group was treated with Guhong injection combined with idebenone.The two groups were compared in terms of clinical efficacy,cognitive function[Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE)scores],hemorheology(plasma viscosity,whole-blood high-shear viscosity,whole-blood low-shear viscosity,fibrinogen),blood flow velocity of cerebral arteries[anterior cerebral arteries(ACA),middle cerebral arteries(MCA),posterior cerebral arteries(PCA)],and the incidence of adverse reactions.Results The total effective rate of 97.44%in the observation group was significantly higher than 84.62%in the control group(P<0.05).After treatment,MoCA and MMSE scores in both groups were significantly higher than those before treatment;MoCA score of(25.67±1.08)points and MMSE score of(25.98±1.65)points in the observation group were significantly higher than(21.69±1.39)and(22.39±1.94)points in the control group(P<0.05).After treatment,the plasma viscosity,whole-blood high-shear viscosity,whole-blood low-shear viscosity and fibrinogen in both groups were significantly lower than those before treatment;in the observation group,the plasma viscosity was(1.53±0.37)mPa·s,the whole-blood high-shear viscosity was(4.98±0.64)mPa·s,the whole-blood low-shear viscosity was(6.98±1.26)mPa·s,and the fibrinogen was(2.18±0.49)g/L,which were significantly lower than(2.16±0.42)mPa·s,(7.26±0.75)mPa·s,(8.26±1.38)mPa·s,and(3.08±0.73)g/L in the control group(P<0.05).After treatment,the blood flow velocity of ACA,MCA and PCA in both groups was significantly higher than those before treatment;in the observation group,the blood flow velocity of ACA,MCA and PCA were(46.89±3.15),(53.17±4.17)and(41.28±3.61)cm/s,which were significantly higher than(43.94±3.77),(50.26±3.58)and(38.15±3.57)cm/s in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In patients with VaD after cerebral infarction,the clinical effect of Guhong injection combined with idibenone is more significant than that of idibenone alone.The cognitive function,hemorheology and cerebral artery flow velocity are significantly improved,and the safety is good.