丁苯酞对迟发性脑病患者精神、行为和认知的影响  

Effects of butylphthalide on mental state,behavior and cognition of patients with delayed encephalopathy

作　　者：陈艳坤 李慧[2] 吴延芝 张友生 张宏丹 顾黎明[5] CHEN Yankun;LI Hui;WU Yanzhi;ZHANG Yousheng;ZHANG Hongdan;GU Liming(Department of Neurology,Heze Municipal Hospital in Shandong Province,Heze 274000,China;Department of Urology,Heze Municipal Hospital in Shandong Province,Heze 274000,China;Department of Emergency Medicine,Heze Municipal Hospital in Shandong Province,Heze 274000,China;Department of Gastroenterology,Heze Municipal Hospital in Shandong Province,Heze 274000,China;Department of Hyperbaric Oxygenation,Heze Municipal Hospital in Shandong Province,Heze 274000,China)

机构地区：[1]山东省菏泽市立医院神经内科,山东菏泽274000 [2]山东省菏泽市立医院泌尿内科,山东菏泽274000 [3]山东省菏泽市立医院急诊科,山东菏泽274000 [4]山东省菏泽市立医院消化内科,山东菏泽274000 [5]山东省菏泽市立医院高压氧科,山东菏泽274000

出　　处：《中国现代医生》2022年第5期22-25,共4页China Modern Doctor

基　　金：山东省医药卫生科技发展计划项目(2020YN26)。

摘　　要：目的探讨丁苯酞对迟发性脑病患者精神、行为和认知的影响。方法选取2017年1月至2019年5月在菏泽市立医院就诊的120例一氧化碳中毒后迟发性脑病患者,随机分为两组。所有患者均置于绝对压力为0.25MPa的高压氧室中,每天80 min,持续90 d;同时每天给予地塞米松5 mg,每周5 d,连续4周。另外,试验组前14 d给予丁苯酞注射液100 ml,每天2次;后76 d每天给予丁苯酞软胶囊200 mg,每天3次。治疗第14天、3个月、1年分别采用MMSE、MoCA、ADL对患者的行为和认知功能进行评估。在第3个月和1年后,用HAMA和HAMD评估患者的精神状态变化。结果治疗第14 d、3个月、1年,试验组的MMSE、MoCA、ADL评分均显著高于对照组,差异有统计学意义(P<0.001)。在治疗后3个月和1年,试验组的HAMA和HAMD评分均显著低于对照组,差异有统计学意义(P<0.001)。结论丁苯酞序贯疗法联合地塞米松、高压氧能明显改善一氧化碳中毒后迟发性脑病患者的精神、行为和认知功能,且无明显副作用。Objective To explore the effects of butylphthalide on mental state,behavior and cognition of patients with delayed encephalopathy.Methods In this experiment,a total of 120 patients with DEACMP who attended Heze Municipal Hospital from January 2017 to May 2019 were randomly divided into two groups(all patients were arranged in a hyperbaric room with an absolute pressure of 0.25 MPa for 80 minutes per day for 90 days.Dexamethasone 5 mg was also given daily for 5 days per week for 4 weeks).In addition,the experimental group was given butylphthalide injection 100 ml twice a day for the first 14 days and butylphthalide softgels 200 mg three times a day for the last 76 days.The behavioral and cognitive functions of the patients were assessed using Mini-mental State Examination(MMSE)scale,montreal cognitive assessment(MoCA)scale,and activity of daily living(ADL)scale at 14 days,3 months,and 1 year of treatment,respectively.Changes in the mental state of patients were assessed by hamilton anxiety scale(HAMA)and hamilton cepression scale(HAMD)at 3 months and 1 year of treatment.Results At 14 days,3 months,and 1 year of treatment,the MMSE,MoCA,and ADL scores in the experimental group were significantly higher than those in the control group,with statistically significant differences(P<0.001).At 3 months and 1 year after treatment,the HAMA and HAMD scores in the experimental group were significantly lower than those in the control group,with statistically significant differences(P<0.001).Conclusion Sequential butylphthalide therapy combined with dexamethasone and hyperbaric oxygen can significantly improve the mental,behavioral and cognitive functions of patients with DEACMP without significant side effects.

关 键 词：丁苯酞 迟发性脑病 精神 高压氧 一氧化碳中毒 

分 类 号：R827.1[医药卫生—临床医学]