血管性认知障碍的药物干预  

Pharmacological treatment of vascular cognitive impairment

作　　者：彭丹[1] 蔡敏[1] 

机构地区：[1]重庆市中山医院神经内科,重庆400013

出　　处：《西部医学》2015年第6期954-957,共4页Medical Journal of West China

基　　金：重庆市卫生局医学科研面上项目(2012-2-193)

摘　　要：目的随着人口老龄化,心脑血管疾病生存率提高,血管性认知障碍发病及患病会在未来几十年明显增多。而且迄今为止没有任何监管机构批准的药物来预防或治疗血管性认知障碍。胆碱酯酶抑制剂和美金刚在血管性痴呆及血管性认知障碍的治疗中显示出良好前景,但对这些药物的临床试验结果仍存在争议,且对其安全性的担忧及高昂费用阻碍这些药物的广泛临床引用;降压药(血管紧张素转换酶抑制剂ACEI)以及他汀类药物的应用可阻止卒中后认知功能减退;目前为止,没有充分证据支持阿司匹林在血管性认知障碍中的治疗作用。对血管性认知障碍的药物干预,仍需要更长时间的前瞻性纵向随访去验证其有效性和安全性。本文就血管性认知功能障碍预防和治疗的药物及临床研究进展综述如下。The prevalence of vascular cognitive impairment （VCI） is likely to increase as the population ages and cardiovascular disease survival improves. There are no pharmacological agents with a regulatory approval for its preven- tion or treatment. Although eholinesterase inhibitors and memantine have small cognitive improvements in patients with VCI, these drugs do not improve global clinical outcomes and have adverse effects and costs. Antihypertensive therapy with ACE inhibitor and statins may prevent the major subtype of VCI known as poststroke cognitive decline. To date, there is no evidence that aspirin has positive treatment function in VCI. More clinical trial evidences are needed to deter- mine the benefits and risks of pharmacologic therapies to prevent and treat VCI.

关 键 词：血管性认知障碍 血管性痴呆 药物治疗 胆碱酯酶抑制剂 美金刚 血管紧张素转换酶抑制剂 他汀类药物 阿司匹林 

分 类 号：R743[医药卫生—神经病学与精神病学] R971[医药卫生—临床医学]