丁苯酞对中重度脑白质疏松患者认知功能和大脑中动脉搏动指数的影响  

Effects of butylphthalide on cognitive function and middle cerebral artery pulsatility index in patients with moderate to severe leukoaraiosis

作　　者：袁志俊 李小刚 何晓英 吴勇 李娇红 

机构地区：[1]西南医科大学附属医院神经内科,四川泸州646099

出　　处：《中国新药与临床杂志》2018年第1期33-37,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：四川省卫生厅项目(110368)

摘　　要：目的探讨丁苯酞对中重度脑白质疏松症(LA)患者的认知功能及大脑中动脉供血的影响。方法收集本院神经内科住院或门诊头颅MRI提示中重度LA,经认知功能简易精神状态量表(MMSE)和蒙特利尔认知量表(MOCA)评分异常的患者100例为认知功能异常组,同时按随机数字表法选取同期中重度LA不伴认知功能异常的患者100例为认知功能正常组,每组随机分为对照组和干预组(均n=50),分别给予常规治疗或常规治疗联合丁苯酞(0.2 g,po,tid),疗程12周。于治疗前后测定MMSE、MOCA量表,事件相关电位P300,以及经颅多普勒超声检查大脑中动脉搏动指数(PI)。结果治疗12周后,认知功能正常组的干预组P300波幅增高、P300潜伏期缩短(P<0.05),PI值降低(P<0.05);认知功能异常组患者的MMSE总分和MOCA总分显著提高、P300电位波幅增高、P300潜伏期缩短、PI值显著降低(均P<0.05);与对照组比较,认知功能异常组的干预组的认知功能改善更为显著(P<0.05),PI值显著降低(P<0.05);治疗前后认知功能正常组和认知功能异常组两组PI值相比均无显著差异(P>0.05)。认知功能异常组PI值与MMSE总分、MOCA总分、P300波幅呈负相关(P<0.05),与P300潜伏期呈正相关(P<0.05)。结论丁苯酞可协同改善中重度LA患者的认知功能及大脑中动脉的PI值。AIM To investigate the effects of butylphthalide on cognitive function and the blood supply ofmiddle cerebral artery activity in patients with moderate to severe leukoaraiosis （LA）. METHODS The patients showed moderate to severe LA from our hospital or outpatient by head MRI were enrolled. Among all, patients with abnormal cognitive function assessed by mini mental state examination （MMSE） scale and Montreal cognitive assessment （MOCA） were selected into cognitive dysfunction group （n = 100）, and 100 patients with normal cognitive function were randomly selected into the normal cognitive function group. Each group was randomly divided into the control group and the intervention group （n = 50）, which were given routine treatment and routine treatment with butylpbthalide （0.2 g, rid, for 12 weeks）, respectively. The MMSE and MOCA scales, event-related potentials P300 were detected, and the middle cerebral artery pulsatility index （PI） was measured by transcranial Doppler before and after the treatment. RESULTS After 12 weeks of the treatment, the P300 amplitude was increased and P300 latency was shortened （P 〈 0.05） , the PI value was decreased in the intervention group of the normal cognitive function group （P 〈 0.05）. The MMSE scores, the MOCA scores and the P300 amplitude were increased （P 〈 0.05）, P300 latency was shortened （P 〈 0.05）, the PI value was decreased in two groups of the cognitive dysfunction group （P 〈 0.05）. Compared with the control group, the cognitive functions were improved significantly （P 〈 0.05） and PI value was lower in the intervention group of the cognitive dysfunction group. There were no significantly differences in PI value between the normal cognitive function group and the cognitive dysfunction group （P 〉 0.05）. The PI value was negatively correlated with the MMSE score, MOCA score, and P300 amplitude in the cognitive dysfunction group （P 〈 0.05）, and was positively correlated with the latency of P300 （P �

关 键 词：丁苯酞 脑白质疏松症 认知障碍 大脑中动脉 搏动血流 

分 类 号：R971[医药卫生—药品]