奥拉西坦联合丁苯酞对非痴呆型血管性认知障碍的疗效  

Efficacy of oxiracetam combined with butylphthalide on vascular cognitive impairment of non-dementia

作　　者：孙佳瑶 唐鹤飞[2] 王静 牛映霞 丁奇 岳丽 SUN Jiayao;TANG Hefei;WANG Jing;NIU Yingxia;DING Qi;YUE Li(The Second Department of Neurology,Zhangjiakou First Hospital,Zhangjiakou 075000,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China;Department of Rehabilitation,Zhangjiakou First Hospital,Zhangjiakou 075000,China;The First Department of Neurology,the First Hospital of Zhangjiakou,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院神经内二科,张家口075000 [2]首都医科大学附属北京天坛医院神经内科,北京100050 [3]张家口市第一医院康复科,张家口075000 [4]张家口市第一医院神经外一科,张家口075000

出　　处：《西北药学杂志》2024年第3期194-199,共6页Northwest Pharmaceutical Journal

基　　金：张家口市重点研发计划项目(编号:2121112D);河北省技术创新引导计划项目(编号:18247788D)。

摘　　要：目的探讨奥拉西坦联合丁苯酞对非痴呆型血管性认知障碍(vascular cognitive impairment of non-dementia,VCIND)患者的临床疗效。方法将64例VCIND患者随机分为对照组与联合组,每组32例。2组均接受常规治疗,对照组给予奥拉西坦治疗,联合组给予奥拉西坦联合丁苯酞治疗,疗程为3个月。比较2组患者治疗前后蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)评分、简易精神状态评价量表(mini mental state evaluation scale,MMSE)、美国国立卫生院卒中量表(national institutes of health stroke scale,NIHSS)评分和日常生活活动能力量表(activity of daily living scale,ADL)评分,检测血清转化生长因子-β(transforming growth factor-β,TGF-β)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、抗凋亡因子(anti-apoptotic factor,Livin)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)和神经生长因子(nerve growth factor,NGF)水平的变化,检测脑血管平均血流速度(mean velocity,V_(m))、动脉搏动指数(pulsatility index,PI)与阻力指数(resistance index,RI)。结果治疗后,2组MoCA、MMSE和ADL评分均升高,NIHSS评分均降低,且联合组MoCA、MMSE和ADL评分显著高于对照组(P<0.05)。2组脑血管V_(m)均升高,PI和RI均降低,且联合组显著优于对照组(P<0.05);2组血清MMP-9NSE均降低,TGF-β、Livin和NGF水平均升高,且联合组显著优于对照组(P<0.05)。结论奥拉西坦联合丁苯酞治疗VCIND可有效改善患者的脑血管功能,保护神经功能及认知功能,其机制可能与纠正血清TGF-β、MMP-9、Livin、NSE及NGF水平有关。Objective To investigate the efficacy of oxiracetam combined with butylphthalide on the cerebral vascular function in patients with vascular cognitive impairment of non-dementia(VCIND).Methods 64 VCIND patients were randomly divided into control group and combination group,with 32 cases in each group.The both groups received conventional treatment,the control group was treated with oxiracetam,and the combination group was treated with oxiracetam combined with butylphthalide for 3 months.The Montreal cognitive assessment scale(MoCA)scores,the mini mental state evaluation scale(MMSE),the national institutes of health stroke scale(NIHSS)scores and the activity of daily living scale(ADL)scores were compared between the 2 groups before and after treatment.The changes of serum transforming growth factor-β(TGF-β),matrix metalloproteinase-9(MMP-9),anti-apoptotic factor(Livin),neuron-specific enolase(NSE)and nerve growth factor(NGF)levels were detected and compared,and the mean velocity(V_(m)),pulsatility index(PI)and resistance index(RI)were detected.Results After treatment,the MoCA,MMSE and ADL scores were significantly increased,and the NIHSS scores were significantly decreased in the 2 groups,and the MoCA,MMSE and ADL scores of the combination group were significantly higher than those of the control group,while the NIHSS scores were significantly lower than the control group(P<0.05).After treatment,the cerebrovascular V_(m) of the 2 groups were significantly increased,the PI and RI in the 2 groups were significantly decreased,and the combination group was significantly better than the control group(P<0.05).After treatment,the serum MMP-9 and NSE were significantly decreased,the TGF-β,Livin and NGF levels were significantly increased in both groups,and the improvement of the combination group were significantly better than the control group(P<0.05).Conclusion Oxiracetam combined with butylphthalide in the treatment of patients with VCIND can effectively improve the cerebrovascular function,protect nerve function an

关 键 词：奥拉西坦 丁苯酞 非痴呆型血管性认知障碍 脑血管功能 转化生长因子-Β 基质金属蛋白酶-9 抗凋亡因子 

分 类 号：R972[医药卫生—药品]