丁苯酞静脉注射序贯口服治疗血管性认知障碍伴高同型半胱氨酸血症疗效观察  

Efficacy of butylphthalide intravenously and sequentially oral in the treatment of vascular cognitive impairment with hyperhomocysteinemia

作　　者：张赟 郭艳平[1] 张向东[1] ZHANG Yun;GUO Yanping;ZHANG Xiangdong(Department of Neurology,Anyang People′s Hospital,Anyang 455000,Henan Province,China)

机构地区：[1]安阳市人民医院神经内科,河南安阳455000

出　　处：《新乡医学院学报》2022年第6期552-556,共5页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20200796)。

摘　　要：目的探讨丁苯酞静脉注射序贯口服治疗血管性认知障碍(VCI)伴高同型半胱氨酸血症(HHcy)患者的临床疗效。方法选择2019年5月至2020年5月安阳市人民医院收治的100例VCI伴HHcy患者为研究对象,根据治疗方法将患者分为观察组和对照组,每组50例。对照组患者给予常规药物治疗,包括口服阿司匹林肠溶片,每次100 mg,每日1次;口服马来酸依那普利片,每次20 mg,每日1次;口服阿托伐他汀钙片,每次20 mg,每日1次;连续治疗3个月。观察组患者在常规药物治疗基础上给予丁苯酞氯化钠注射液100 mL(含丁苯酞25 mg),静脉滴注,每日2次,连续治疗14 d后改为口服丁苯酞软胶囊0.2 g,每日3次,累计治疗3个月。治疗后2组患者随访6个月。分别于治疗前及治疗1、3个月和治疗后3、6个月,采用简易智力状态检查(MMSE)量表评估患者的智力状态;采用蒙特利尔认知评估(MoCA)量表评估患者的认知功能;采用日常生活能力量表(ADL)评估患者的日常生活能力。结果对照组患者治疗3个月及治疗后3、6个月的MMSE评分显著高于治疗前(P<0.05);观察组患者治疗1、3个月及治疗后3、6个月的MMSE评分显著高于治疗前(P<0.05);治疗1、3个月及治疗后3、6个月,2组患者的MMSE评分均呈升高趋势,且观察组患者的MMSE评分显著高于对照组(P<0.05)。2组患者治疗3个月及治疗后3、6个月的MoCA评分显著高于治疗前(P<0.05);治疗1、3个月及治疗后3、6个月,2组患者的MoCA评分均呈升高趋势(P<0.05);治疗3个月及治疗后3、6个月,观察组患者的MoCA评分显著高于对照组(P<0.05)。2组患者治疗1、3个月及治疗后3、6个月的ADL评分均显著高于治疗前(P<0.05);治疗1、3个月及治疗后3、6个月,2组患者的ADL评分均呈升高趋势(P<0.05),且观察组患者的ADL评分显著高于对照组(P<0.05)。结论常规药物联合丁苯酞静脉注射序贯口服治疗可有效改善VCI伴HHcy患者智力状态、认知功�Objective To explore the clinical efficacy of butylphthalide intravenously and sequentially oral in the treatment of vascular cognitive impairment(VCI)with hyperhomocysteinemia(HHcy).Methods A total of 100 patients with VCI and HHcy admitted to the Anyang People′s Hospital from May 2019 to May 2020 were selected as the research objects.According to treatment methods,the patients were divided into control group and observation group,with 50 cases in each group.The patients in the control group were given conventional drug therapy,included taking aspirin enteric-coated tablets orally,100 mg each time,once a day;taking enalapril maleate tablets orally,5 mg each time,once a day;taking atorvastatin calcium tablets orally,20 mg each time,once a day;the treatment lasted for 3 months.On the basis of routine drug treatment,the patients in the observation group were given butylphthalide sodium chloride injection intravenously,100 mL each time(containing 25 mg of butylphthalide),twice a day;after 14 days of continuous treatment,the patients were changed to take butylphthalide soft capsules orally,0.2 g each time,3 times a day,and the treatment lasted for 3 months.After treatment,the patients in the two groups were followed up for 6 months.Before treatment,after 1 and 3 months of treatment,at 3 and 6 months after treatment,the mental state of the patients was assessed by the mini-mental state examination(MMSE)scale;the cognitive function of the patients was evaluated by the montreal cognitive assessment(MoCA)scale;the ability of daily living of patients was evaluated by the activities of daily living scale(ADL).Results The MMSE scores of patients in the control group after 3 months of treatment and at 3,6 months after treatment were significantly higher than those before treatment(P<0.05);the MMSE scores of patients in the observation group after 1,3 months of treatment and at 3,6 months after treatment were significantly higher than those before treatment(P<0.05);after 1,3 months of treatment and at 3,6 months after treat

关 键 词：血管性认知障碍 高同型半胱氨酸血症 丁苯酞 认知功能 

分 类 号：R749.1[医药卫生—神经病学与精神病学]