胞磷胆碱对大脑中动脉狭窄患者轻度认知功能障碍的影响  

Effect of citicoline on mild cognitive impairment in patients with middle cerebral artery stenosis

作　　者：刘炫君[1] 杨国帅[1] 胡裕洁 程启慧 吴海燕 周律 张艳君 

机构地区：[1]中南大学湘雅医学院附属海口医院神经内科,570208

出　　处：《中华老年心脑血管病杂志》2018年第2期179-183,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：海南省自然科学基金(20158272);海口市重点科技计划(2014-073)

摘　　要：目的探讨胞磷胆碱对大脑中动脉狭窄患者轻度认知功能障碍的影响。方法选择2014年10月~2016年10月在中南大学湘雅医学院附属海口医院神经内科就诊的大脑中动脉狭窄合并轻度认知功能障碍患者86例,随机分为胞磷胆碱组44例和对照组42例。胞磷胆碱组在常规治疗基础上从入院后开始给予胞磷胆碱胶囊0.2g 3次/d,持续6个月。应用经颅多普勒超声对2组患者治疗后脑血管储备、搏动指数、屏气指数及大脑中动脉狭窄平均流速(Vm)上升率进行评定,应用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)对2组患者治疗后轻度认知功能障碍进行评定。结果与对照组比较,胞磷胆碱组治疗后脑血管储备[(13.59±1.16)%vs(7.61±1.12)%,P<0.01]、搏动指数(0.51±0.16 vs 0.58±0.12,P<0.05)、屏气指数(1.36±0.08 vs 0.74±0.11,P<0.01)、Vm上升率[(32.63±2.32)%vs(16.92±1.68)%,P<0.05]明显改善。与对照组比较,胞磷胆碱组治疗后MoCA总分及各分项注意力、语言功能、视空间与执行功能、抽象概括能力、命名、定向力、记忆能力较对照组明显升高,差异有统计学意义(P<0.01)。结论大脑中动脉狭窄合并轻度认知功能障碍患者存在脑血管储备受损,早期给予胞磷胆碱治疗能改善脑血管储备,并减轻患者轻度认知功能障碍。Objective To study the effect of citicoline on mild cognitive impairment （MCI） in pa- tients with middle cerebral artery stenosis （MCAS）. Methods Eighty-six MCAS patients with MCI were divided into citicoline group （n=44） and control group （n=42）. The patients in citicoline group were treated with citicoline （0.2 g,3 times a day） for 6 months on the basis of conventional treatment. Cerebrovascular reserve, P], BHI and Vm between the two groups were com- pared by transcranial Doppler ultrasonography after treatment. MCI between the two groups was assessed according to the MoCA after treatment. Results The rate of cerebrovascular reserve,PI, BHI and Vm were significantly higher in citicoline group than in control group （13.59± 1.16% vs 7.61±1.12 % ,P〈0.01;0.51±0.16 vs 0. 58±0.12,P〈0.05;1.36±0.08 vs 0. 74±0. 11,P〈 0.01 ;32.63% ±2. 32% vs 16. 92% ± 1. 68%,P〈0.05）. The total MoCA score, attention, language, visuospatial and executive function, abstract, naming, orientation and memory were signifi- cantly higher in citicoline group than in control group （P〈0.01）. Conclusion Early citicoline treatment can improve cerebrovascular reserve and alleviate MCI in MCAS patients.

关 键 词：胞苷二磷酸胆碱 大脑中动脉 认知障碍 超声检查 多普勒 经颅 

分 类 号：R743.3[医药卫生—神经病学与精神病学]