张量成像在丁苯酞氯化钠治疗脑梗死患者认知功能评估中的应用价值  

Clinical study of diffusion tensoRimaging in the evaluation of cognitive function of cerebral infarction patients treated with butylphthalide sodium chloride

作　　者：李娟 吴艳峰 薛嘉海 段凯强 LI Juan;WU Yanfeng;XUE Jiahai(Department of Emergency,Zhangjiakou First Hospital,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北省张家口市第一医院急诊科,075000 [2]河北省张家口市第一医院放射医学科,075000

出　　处：《河北医药》2024年第11期1682-1685,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20221896)。

摘　　要：目的探讨磁共振弥散张量成像(DTI)在丁苯酞氯化钠治疗脑梗死患者认知功能评估中的临床应用效果。方法选择2021年1月至2022年12月收治的40例脑梗死患者,根据随机数表法将其分为甲组和乙组,每组20例。2组均予以常规对症治疗,甲组在此基础上予以重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗,乙组在甲组基础上行丁苯酞氯化钠治疗。2组治疗前、后均对其开展DTI检查。观察2组疗效、纤溶指标、神经功能缺损情况、认知功能水平及DTI检查结果。结果乙组临床疗效优于甲组,差异有统计学意义(P<0.05);2组治疗后血清D-二聚体(D-D)水平、血浆1型纤维蛋白溶解酶原激活抑制剂(PAI-1)水平及血浆纤维蛋白原(FIB)水平均较治疗前下降,且乙组低于甲组,差异有统计学意义(P<0.05);2组治疗后美国国立卫生研究院卒中量表(NIHSS)评分均低于治疗前,蒙特利尔认知评估量表(MoCA)评分均高于治疗前,且乙组NIHSS评分低于甲组,MoCA评分高于甲组,差异有统计学意义(P<0.05);2组治疗后DTI检查各向异性(FA)值均较治疗前提高,且乙组高于甲组,差异有统计学意义(P<0.05)。结论rt-PA静脉溶栓联合丁苯酞氯化钠辅助治疗脑梗死疗效确切,有助于改善患者神经功能及认知功能,通过DTI检查可有效评估患者认知功能变化,对预测患者预后有积极作用。Objective To explore the clinical application of diffusion tensoRimaging(DTI)in the evaluation of cognitive function in cerebral infarction patients treated with butylphthalide sodium chloride.Methods Forty patients with cerebral infarction admitted to ouRhospital from January 2021 to DecembeR2022 were randomly assigned into group A(n=20)and group B(n=20).Routine symptomatic treatment and intravenous thrombolytic therapy using recombinant tissue plasminogen activatoR(rt-PA)were performed in both groups.Butylphthalide sodium chloride was additionally given to patients of group B.DTI was performed before and afteRtreatment in both groups.The curative effect,fibrinolytic indicators,neurological deficits,cognitive function level and DTI data were observed in the two groups.Results The clinical efficacy of group B was significantly higheRthan that of group A(P<0.05).AfteRtreatment,serum D-dimeR(D-D),plasma plasminogen activatoRinhibitoRtype 1(PAI-1),and plasma fibrinogen(FIB)levels were significantly reduced in both groups,which were significantly loweRin group B than those of group A(P<0.05).Significantly reduced National Institute of Health Stroke Scale(NIHSS)score and elevated Montreal Cognitive Assessment Scale(MoCA)score were observed in both groups afteRtreatment,which were more pronounced in group B than those of group A(P<0.05).The fractional anisotropy(FA)in DTI was elevated afteRtreatment in both groups,which was more pronounced in group B than that of group A(P<0.05).Conclusion Intravenous thrombolytic therapy using rt-PA combined with butylphthalide sodium chloride is effective in the treatment of cerebral infarction,which is helpful to improve the neurological and cognitive functions.DTI can effectively evaluate the changes of cognitive function,showing a positive role in predicting the prognosis.

关 键 词：磁共振弥散张量成像 丁苯酞氯化钠 脑梗死 认知功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]