摘要
目的观察舒血宁联合长春西汀对血管性认知功能障碍(VCI)患者脑血灌注情况和认知功能障碍的影响。方法选取2015年3月—2018年2月重庆市开州区人民医院神经内科收治的VCI患者284例为研究对象,采用随机数字表法分为观察组及对照组,每组142例。对照组给予长春西汀治疗,观察组则在对照组基础上联合舒血宁治疗。比较2组治疗前及治疗2周后脑血流灌注情况[大脑中动脉(MCA)收缩期最大血流速度(Vmax)、舒张期最小血流速度(Vmin)、平均血流量(Qmean)、阻力指数(RI)]、血液流变学指标[全血高切黏度(HS)、全血低切黏度(LS)、血浆黏度(PV)]、血清学指标[过氧化脂质(LPO)、血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)]、认知功能[长谷川式认知功能障碍量表(HDS)、简易精神状态检查表(MMSE)]差异。结果治疗2周后,2组大脑中动脉Vmax、Vmin、Qmean、VEGF、BDNF、HDS、MMSE评分、均较治疗前升高(t_(对照组)=13. 911、29. 351、12. 888、11. 832、19. 333、8. 567、14. 433,t_(观察组)=20. 469、50. 064、25. 511、19. 781、30. 105、14. 406、22. 912,P均<0. 01),RI、HS、LS、PV、血清LPO水平则较治疗前降低(t_(对照组)=3. 405、15. 016、15. 002、15. 268、39. 504,t_(观察组)=2. 657、24. 487、22. 278、26. 613、52. 843,P均<0. 01),且观察组变化幅度均大于对照组(t=5. 453、13. 530、8. 685、4. 416、6. 824、3. 755、5. 332、6. 272、6. 502、6. 030、6. 408、7. 054,P均<0. 01)。结论舒血宁联合长春西汀对VCI患者近期治疗效果较好,可提高患者脑血流灌注量,并改善机体血液流变学指标,也能缓解氧化应激反应,且使神经细胞损伤降低,对促进患者认知功能恢复有积极意义。
Objective To observe the effects of Shuxuening combined with vinpocetine on cerebral blood perfusion and cognitive impairment in patients with vascular dementia(VCI).Methods 284 cases of VCI patients admitted to department of neurology of the People’s Hospital of Kaizhou District from March 2015 to February 2018 were selected for the study and divided into observation group(n=142)and control group(n=142)according to the random number table method.Control group was given vinpocetine,and observation group was given Shuxuening on the basis of control group.The cerebral blood perfusion[systolic maximum flow velocity(Vmax)of middle cerebral artery(MCA),diastolic minimum flow velocity(Vmin),mean blood flow(Qmean)and resistance index(RI)],hemorheology indexes[high blood viscosity(HS),low blood viscosity(LS),plasma viscosity(PV)],serological parameters[lipid peroxide(LPO),vascular endothelial growth factor(VEGF),brain-derived neurotrophic factor(BDNF)]and cognitive function[Hasegawa Dementia Scale(HDS),Mini-Mental State Examination(MMSE)]were compared between the two groups before treatment and after 2w of treatment.Results After 2w of treatment,MCA Vmax,Vmin,Qmean,VEGF,BDNF,HDS,MMSE scores were all higher than those before treatment(Control group:t=13.911,t=29.351,t=12.888,t=11.832,t=19.333,t=8.567,t=14.433,observation group:t=20.469,t=50.064,t=25.511,t=19.781,t=30.105,t=14.406,t=22.912,all P<0.01),RI,HS,LS,PV,serum LPO were lower than those before treatment(Control group:t=3.405,t=15.016,t=15.002,t=15.268,t=39.504,observation group:t=2.657,t=24.487,t=22.278,t=26.613,t=52.843,all P<0.01),and the changes in observation group were larger than those in control group(t=5.453,t=13.530,t=8.685,t=4.416,t=6.824,t=3.755,t=5.332,t=6.272,t=6.502,t=6.030,t=6.408,t=7.054,all P<0.01).Conclusion Shuxuening combined with vinpocetine for VCI patients can have good recent treatment effects,and it can improve the cerebral blood perfusion and hemorheology indexes,alleviate the oxidative stress reaction,and reduce the injury of nerve cells,and it has positive significance in promoting the recovery of cognitive function.
作者
彭川
吴修华
骆涛
PENG Chuan;WU Xiuhua;LUO Tao(Department of Neurology,the People’s Hospital of Kaizhou District,Chongqing 405400,China)
出处
《疑难病杂志》
CAS
2018年第11期1209-1212,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
认知功能障碍
血管性
舒血宁
长春西汀
脑血流灌注
Cognitive impairment,vascular
Shuxuening
Vinpocetine
Cerebral blood perfusion
