经颅磁刺激联合普罗布考治疗急性脑梗死后血管性认知功能障碍研究  

Therapeutic effects of transcranial magnetic stimulation combined with probucol on vascular cognitive impairment in patients with acute cerebral infarction

作　　者：王军英[1] 段毅[1] 赵平平[1] 王坤[1] 张云书[1] 高瑞利[1] 张莉[1] WANG Junying;DUAN Yi;ZHAO Pingping(The Third Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市第三医院神经内科,050011

出　　处：《河北医药》2020年第20期3089-3093,共5页Hebei Medical Journal

基　　金：石家庄市科技局课题(编号:171792043)。

摘　　要：目的对急性脑梗死后发生血管性认知功能障碍的患者进行经颅磁刺激和普罗布考联合治疗,观察此联合治疗的临床治疗效果。方法选择2017年6月至2018年6月接受诊治的急性脑梗死后血管性认知功能障碍患者共120例,随机分为对照组和联合治疗组,每组60例。联合治疗组在常规治疗脑梗死药物基础上加用经颅磁刺激联合普罗布考500 mg,口服,3次/d治疗,对照组给予常规治疗脑梗死药物。于4周后应用简易精神状态检查表(MMSE)和日常生活能力量表(ADL)评估患者认知功能,应用酶联免疫吸附实验检测血清S100β蛋白、神经元特异性烯醇化酶(NSE)和脑源性神经营养因子(BDNF)含量,并观察用药后超敏-C反应蛋白变化、血脂、肝肾功能指标及不良反应。结果治疗后,与对照组项目,联合治疗组MMSE评分和ADL评分均明显增高,差异均有统计学意义(P<0.05)。同时联合治疗组血清S100β蛋白和NSE含量明显低于对照组,血清BDNF含量明显高于对照组,差异均有统计学意义(P<0.05)。此外,联合治疗组超敏-C反应蛋白及血脂含量均明显低于对照组,差异有统计学意义(P<0.05)。结论经颅磁刺激联合普罗布考治疗可明显改善急性脑梗死后血管性认知功能障碍患者的认知功能,提高患者生活质量,且安全,无明显副作用,具有非常重要的临床应用价值。Objective To investigate the therapeutic effects of transcranial magnetic stimulation(TMS)combined with probucol on vascular cognitive impairment(VCI)in patients with acute cerebral infarction.Methods A total of 120 patients with VCI after acute cerebral infarction,who were treated in our hospital from June 2017 to June 2018,were randomly divided into combination treatment group(n=60)and control group(n=60).The patients in control group were treated by conventional drugs,however,the patients in combination group were treated by TMS combined with probucol(500mg orally,3 times daily for 3 days)on the basis of conventional treatment.Minimental state examination(MMSE)and activities of daily living(ADL)score were used to evaluate the cognitive function of the patients.ELISA was used to detect the content of S100β,NSE and BDNF.In addition,the changes of hypersensitive C reactive protein,blood lipids,liver and kidney function indexes as well as adverse reactions were observed and compared between the two groups.Results After treatment,the scores of MMSE and ADL in combination treatment group were significantly increased,as compared with those in control group(P<0.05).The levels of S100βand NSE in combination treatment group were significantly lower than those in control gooup,however,the levels of BDNF were significantly higher than those in control group(P<0.05).Moreover,the levels of high-sensitivity C-reactive protein and blood lipids in combination treatment group were significantly lower than those in control gooup(P<0.05).Conclusion The transcranial magnetic stimulation combined with probucol can significantly improve the cognitive function of patients with VCI after acute cerebral infarction,improve the life quality of patients,with safety and without obviuos side effects,therfor,it is of quite important clinical application value.

关 键 词：经颅磁刺激 普罗布考 急性脑梗死 血管性认知障碍 认知功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]