血管内支架成形术与尼莫地平在治疗血管性认知功能障碍的对比研究  

Endovascular stent angioplasty and orally administered nimodipine for vascular cognitive impairment: a comparative study

作　　者：孙鹏[1] 隋守光[1] 施洪峰[1] 肖颖[1] 李海停[1] 张晓飞[1] 李玮[1] 王宁[1] 

机构地区：[1]山东滨州医学院附属东营市胜利油田中心医院血管·神经介入科,257034

出　　处：《介入放射学杂志》2013年第3期190-192,共3页Journal of Interventional Radiology

摘　　要：目的初步评价血管内支架成形术与尼莫地平在治疗血管性认知功能障碍(vascularcognitive impairment,VCI)的疗效。方法 2009年6月至2011年6月诊断符合"第四届全国脑血管病会议"修订标准的VCI患者40例,经全脑血管造影术或头颈部CT血管成像确诊为脑供血动脉狭窄,并达到血管内治疗标准。将患者分为血管内支架成形术治疗组(支架组,20例)和口服尼莫地平治疗组(尼莫地平组,20例),接受治疗前行认知功能测定,用简易精神状态量表(MMSE)评分,并于治疗后6 h内和1、3、6个月分别行认知功能测定,观察各指标变化情况。结果治疗前支架组与尼莫地平组比较,MMSE评分差异无统计学意义(P>0.05)。治疗后1、3、6个月支架组MMSE评分较尼莫地平组显著升高,差异有统计学意义(P<0.05)。支架组患者术后6 h内和1、3、6个月的MMSE评分与术前比较差异均有统计学意义(P<0.05),而尼莫地平组仅在术后6个月的MMSE评分较术前差异有统计学意义(P<0.05)。结论血管内支架成形术和口服尼莫地平治疗VCI均有效。血管内支架成形术后认知功能在短时间内得到改善,尼莫地平治疗则需较长时间才能改善。Objective To preliminary evaluate the clinical effect of orally administered nimodipine and endovascular stent angioplasty in treating the vascular cognitive impairment （VCI）. Methods A total of 40 patients with VCI, who were encountered at authors＇ hospital during the period from June 2009 to June 2011, were enrolled in this study. The diagnosis of CVI was fully consistent with the modified standard suggested by the ＂Fourth National Stroke Conference＂. Cerebral artery stenosis was confirmed by cerebral angiography or CTA in all patients. The patients were divided into stent group （n = 20） and orally administered nimodipine group （n = 20）. Before the treatment the cognitive function was estimated by minimental state examination （MMSE） score. At 6 hours, one, 3 and 6 months after the treatment, the cognitive function was estimated again, and the changes in the relevant indexes were recorded. The results were statistically analyzed and compared between the two groups. Results Before the treatment, the difference in MMSE scores between the two groups was not significant （P 〉 0.05）. At one, 3 and 6 months after the treatment, the MMSE scores of the stent group were significantly higher that those of the orally administered nimodipine group, the difference between the two groups was statistically significant （P 〈 0.05）. In the stent group the MMSE scores estimated at 6 hours, one, 3 and 6 months after the treatment were significantly different from those obtained before the treatment （P 〈 0.05）, while in the orally administered nimodipine group statistically significant difference in MMSE scores only existed between preoperative MMSE scores and postoperative 6- month ones （P 〈 0.05）. Conclusion Both endovascular stent angioplasty and orally administered nimodipine are effective treatment for vascular cognitive impairment. The cognitive function can be improved in a short time when endovascular stent angioplasty is carried out. When orally administered nimodipine is employe

关 键 词：血管性认知功能障碍 支架成形术 尼莫地平 疗效 

分 类 号：R749.1[医药卫生—神经病学与精神病学]