甲钴胺联合多奈哌齐治疗脑小血管病致认知功能障碍的效果  

Clinical effect of mecobalamin combined with donepezil in the treatment of cognitive dysfunction caused by cerebral small vessel disease

作　　者：陆高平 张建安[1] 欧阳樱君[1] LU Gao-ping;ZHANG Jia-nan;OUYANG Ying-jun(Department of Nepartment,Guangzhou First People's Hospital Xansha Hospital,Guangzhou 511457,Guangdong,China)

机构地区：[1]广州市第一人民医院南沙医院神经内科,广东广州511457

出　　处：《广东医学》2021年第10期1211-1214,共4页Guangdong Medical Journal

摘　　要：目的观察甲钴胺联合多奈哌齐对脑小血管病认知功能障碍的治疗效果。方法入组80例脑小血管病致认知功能障碍患者,随机分为对照组和观察组,对照组40例给予口服多奈哌齐治疗,观察组40例给予口服多奈哌齐+甲钴胺分散片治疗。使用蒙特利尔认知评估量表(MoCA)与简易智力状态检查量表(MMSE)对患者认知功能进行评估,并观察两组患者治疗前和治疗3个月后超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平的变化。结果两组患者治疗后MoCA和MMSE总分均较治疗前明显升高(P<0.05),且治疗后观察组的MoCA[(23.83±2.62)分]和MMSE总分[(25.63±2.95)分]明显高于对照组(P<0.05),两组患者治疗后hs-CRP、Hcy水平均较治疗前明显下降(P<0.05),且治疗后观察组hs-CRP[(2.42±0.80)mg/L]和Hcy[(11.86±1.23)μmol/L]水平明显低于对照组(P<0.05),观察组总有效率高于对照组(60.0%vs.37.5%,P<0.05)。结论联合使用甲钴胺和多奈哌齐可明显提高脑小血管病患者认知功能水平,且可以使血清hs-CRP和Hcy水平明显降低。Objective To observe the clinical effect of mecobalamin combined with donepezil in treatment of cognitive dysfunction caused by cerebral small vessel disease.Methods Patients(80 cases)with cerebrovascular cognitive impairment were randomly divided into control and observation groups.Forty cases in control group were given with donepezil,and 40 cases in observation group were given with mecobalamin plus donepezil.The cognitive function of the patients was evaluated with the Montreal cognitive assessment scale(MoCA)and mini-mental state examination(MMSE).The levels of high sensitive C reactive protein(hs-CRP)and homocysteine(Hcy)were measured before and 3 months after treatment.Results After treatment,the MoCA and MMSE scores of both groups were significantly improved(P<0.05),and the MoCA score(23.83±2.62)and MMSE score(25.63±2.95)in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the serum levels of hs-CRP and Hcy in both groups were significantly lower than those before treatment(P<0.05),while the hs-CRP[(2.42±0.80)mg/L]and Hcy[(11.86±1.23)μmol/L]levels in the observation group were significantly lower than those in the control group(P<0.05).Total efficiency of observation group(60.0%)was significantly higher than that of control group(37.5%)(P<0.05).Conclusion Mecobalamin combined with donepezil can significantly improve the cognitive function,and reduce serum hs-CRP and Hcy levels.

关 键 词：脑小血管病 认知功能障碍 多奈哌齐 甲钴胺 

分 类 号：R741.05[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]