肝豆灵片联合奥拉西坦注射液对Wilson病患者认知障碍的影响  

The effect of Gandouling Tablets combined with Oxiracetam Injection on cognitive impairment in patients with Wilson’s disease

作　　者：黄晓峰[1] 谢道俊[1] 张娟[1] HUANG Xiaofeng;XIE Daojun;ZHANG Juan(First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230038)

机构地区：[1]安徽中医药大学第一附属医院,合肥230038

出　　处：《现代中医临床》2025年第1期15-20,共6页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金项目(No.81874389)。

摘　　要：目的分析Wilson病(Wilson disease,WD)认知障碍危险因素,并观察肝豆灵片联合奥拉西坦注射液治疗WD认知障碍的临床疗效。方法将108例WD患者分为WD认知障碍组和WD不伴认知障碍组,对2组患者的一般资料进行比较,在此基础上运用Logistic回归分析WD认知障碍危险因素。将48例WD认知障碍患者分为奥拉西坦组和联合治疗组,2组患者在常规治疗基础上分别加用奥拉西坦注射液及肝豆灵片联合奥拉西坦注射液,连续使用3个疗程后评估患者简易智力状态检查量表(Mini-mental state examination,MMSE)、蒙特利尔认知评估量表(montreal cognitive assessment scale,MoCA)和日常生活能力评定量表(activity of daily living scale,ADL)量表得分。结果WD患者认知障碍发病率为44.44%,其中轻度认知障碍占62.50%,中度认知障碍占29.17%,重度认知障碍占8.33%。UWDRS评分和血清铜是WD认知障碍的独立危险因素,而UA水平是认知障碍的保护性因素。奥拉西坦组和联合治疗组MMSE评分、MoCA评分和ADL评分较治疗前均有提高,且联合治疗组评分提高更加明显,与奥拉西坦组比较有统计学差异。结论WD认知障碍发病率高,以轻中度认知损害为主。疾病严重程度、血清铜水平和尿酸水平是WD认知障碍的影响因素。肝豆灵片联合奥拉西坦注射液治疗WD认知障碍疗效显著。Objective To analyze the risk factors of cognitive impairment in Wilson’s disease(WD)and observe the clinical efficacy of Gandouling Tablets combined with Oxiracetam Injection in the treatment of cognitive impairment in WD.Methods 108 patients with WD were divided into the cognitive impairment group and the non-cognitive impairment group.The general data of the two groups were compared,and logistic regression analysis was used to analyze the risk factors for WD cognitive impairment.The 48 patients with cognitive impairment were divided into the Oxiracetam group and the combination therapy group.On the basis of routine treatment,the two groups of patients were given Oxiracetam Injection and Ganduling Tablets combined with Oxiracetam Injection.After 3 consecutive courses of use,the MMSE,MoCA,and ADL scores of the patients were evaluated.Results 1)The incidence rate of cognitive impairment in WD patients was 44.44%,of which 62.50% were mild cognitive impairment,29.17% moderate,and 8.33% severe.(2)UWDRS score,and serum copper levels are independent risk factors for cognitive impairment in WD,while UA levels are a protective factor.(3)The MMSE score,MoCA score,and ADL score of the Oxiracetam group and the combination therapy group both improved compared to before treatment,and the score of the combination therapy group improved more significantly,with statistical differences compared to the Oxiracetam group.Conclusion The incidence rate of cognitive impairment in WD is high,with mild to moderate cognitive impairment as the main factor.Disease severity,serum copper levels,and uric acid levels are influencing factors for cognitive impairment in WD.The combination of Gandouling Tablets and Oxiracetam Injection has significant therapeutic efficacy on cognitive impairment in WD.

关 键 词：WILSON病 认知损害 危险因素 肝豆灵片 奥拉西坦注射液 

分 类 号：R259[医药卫生—中西医结合]