胞磷胆碱联合美金刚治疗血管性痴呆的临床研究  

Clinical study on citicoline combined with memantine in treatment of vascular dementia

作　　者：李娟[1] 高志强[1] 高俊风[1] 刘玮[1] 段磊[1] LI Juan;GAO Zhi-qiang;GAO Jun-feng;LIU Wei;DUAN Lei(Depatment of Internal Medicine-Neurology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第二附属医院神经内科,江苏南京210011

出　　处：《现代药物与临床》2018年第9期2218-2221,共4页Drugs & Clinic

摘　　要：目的探讨胞磷胆碱钠联合美金刚治疗血管性痴呆的临床疗效。方法选取2015年1月—2018年2月在南京医科大学第二附属医院治疗血管性痴呆患者84例,随机分为对照组(42例)和治疗组(42例)。对照组口服盐酸美金刚片,第1周5 mg/次,1次/d,第2周5 mg/次,2次/d,第3周早晨10 mg/次,下午5 mg/次,维持剂量10 mg/次,2次/d;治疗组在对照组基础上口服胞磷胆碱钠片,0.2 g/次,3次/d。两组患者均经过4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者简易智力状态检查量表(MMSE)、长谷川痴呆量表(HDS)、蒙特利尔认知评估量表(Mo CA)和日常生活能力(ADL)评分及血清学指标。结果治疗后,对照组和治疗组临床总有效率分别为80.95%和95.24%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组MMSE量表评分、HDS量表评分、Mo CA量表评分、ADL量表评分均明显升高(P<0.05),且治疗组上述评分明显高于对照组(P<0.05)。治疗后,两组血清同型半胱氨酸(Hcy)、白细胞介素-6(IL-6)水平均显著降低(P<0.05),降钙素基因相关肽(CGRP)和脑源性神经营养因子(BDNF)水平显著升高(P<0.05),且治疗组血清学指标改善程度明显优于对照组(P<0.05)。结论胞磷胆碱钠联合美金刚治疗血管性痴呆可有效改善患者认知和行为功能,提高日常生活能力,具有一定的临床推广应用价值。Objective To investigate the clinical effect of citicoline combined with memantine in treatment of vascular dementia. Methods Patients（84 cases） with vascular dementia in the Second Affiliated Hospital of Nanjing Medical University from January 2015 to February 2018 were randomly divided into control（42 cases） and treatment（42 cases） groups. Patients in the control group were po administered with Memantine Hydrochloride Tablet, 5 mg/time for the 1 st week, once daily, twice daily for the 2 nd week, 10 mg/time in the morning and 5 mg/time in the afternoon of the third week, then the maintenance dose was 10 mg/time, twice daily. Patients in the treatment group were po administered with Citicoline Sodium Tablets on the basis of the control group, 0.2 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and MMSE, HDS, Mo CA and ADL scores, and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.95% and 95.24% respectively, and there were differences between two groups（P 〈 0.05）. After treatment, the MMSE, HDS Mo CA and ADL scores in two groups were significantly increased（P 〈 0.05）, and these scores in the treatment group after treatment were significantly higher than those in the control group（P 〈 0.05）. After treatment, the serum Hcy and IL-6 levels in two groups were significantly decreased（P 〈 0.05）, CGRP and BDNF levels were significantly increased（P 〈 0.05）, and the serological indexes in the treatment group after treatment were significantly better than those in the control group（P 〈 0.05）. Conclusion Citicoline combined with memantine in treatment of vascular dementia can improve cognitive and behavioral function, enhance the ability of daily life, which has a certain clinical application value.

关 键 词：胞磷胆碱钠片 盐酸美金刚片 血管性痴呆 简易智力状态检查量表 长谷川痴呆量表 同型半胱氨酸 降钙素基因相关肽 脑源性神经营养因子 

分 类 号：R914[医药卫生—药物化学]