氢溴酸加兰他敏治疗脑卒中后轻度认知功能障碍患者的效果  

Efficacy of galantamine hydrobromide in treatment of mild cognitive impairment after stroke

作　　者：吴亚平 孙文强 纪海霞 王洪亮 Wu Ya-ping;Sun Wen-qiang;Ji Hai-xia;Wang Hong-liang(Department of Neurology,Nantong Sixth People’s Hospital,Nantong 226000,China)

机构地区：[1]南通市第六人民医院神经内科,南通226000

出　　处：《中国药物应用与监测》2025年第1期5-8,17,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨氢溴酸加兰他敏治疗脑卒中后轻度认知功能障碍的效果及对血清同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)水平的影响。方法通过随机数表法将南通市第六人民医院2022年2月至2023年8月收治的120例脑卒中后轻度认知功能障碍患者分为两组。对照组60例患者接受标准化脑卒中治疗,观察组60例患者在对照组基础上加用氢溴酸加兰他敏片治疗,连续用药3个月。对比分析两组治疗前后血清NSE、Hcy水平和认知功能,评估两组临床疗效及不良反应发生情况。结果治疗后,对照组和观察组患者血清NSE、Hcy水平[分别为(20.86±3.03)pg·mL^(-1) vs(16.24±2.76)pg·mL^(-1)、(19.78±3.16)μmol·L^(-1) vs(16.35±3.09)μmol·L^(-1)],均低于治疗前[分别为(27.04±3.68)pg·mL^(-1) vs(27.61±3.54)pg·mL^(-1)、(22.88±3.84)μmol·L^(-1) vs(23.14±3.62)μmol·L^(-1)],且观察组血清NSE、Hcy水平低于对照组(t=8.731、6.011,均P<0.05);治疗后,对照组和观察组患者蒙特利尔认知功能评估量表(MOCA)、简易精神状态检查量表(MMSE)得分[分别为(21.28±2.16)分vs(24.35±2.55)分、(21.86±2.53)分vs(25.61±2.28)分],均高于治疗前[分别为(19.92±2.64)分vs(19.32±2.06)分、(17.06±1.48)分vs(17.28±1.59)分],且观察组MMSE、MOCA得分高于对照组(t=8.529、7.116,均P<0.05);观察组治疗总有效率为96.67%(58/60),高于对照组的81.67%(49/60)(χ^(2)=6.988,P=0.008);在不良反应发生率方面,观察组为15.00%(9/60),相较于对照组的10.00%(6/60)更高,但组间对比差异无统计学意义(χ^(2)=0.686,P=0.408)。结论氢溴酸加兰他敏治疗脑卒中后轻度认知功能障碍患者的效果及安全性较好,能改善患者的认知功能,降低患者的血清NSE、Hcy水平。Objective To explore the efficacy of galantamine hydrobromide in treatment of patients with mild cognitive impairment after stroke and its effect on serum levels of neuron specific enolase(NSE)and homocysteine(Hcy).Methods A total of 120 patients with mild cognitive impairment after stroke admitted to Nantong Sixth People’s Hospital from February 2022 to August 2023 were divided into two groups using a random number table method.The 60 patients in the control group received standardized stroke treatment while the other 60 patients in the observation group were treated with galantamine hydrobromide tablets based on the regimen in the control group for a continuous period of 3 months.The serum NSE,Hcy levels,cognitive function scores before and after treatment were compared between the two groups.The clinical efficacy and incidence of adverse reactions were also evaluated.Results After treatment,the serum levels of NSE and Hcy in the control group and observation group were(20.86±3.03)pg·mL^(-1) vs(16.24±2.76)pg·mL^(-1),(19.78±3.16)μmol·L^(-1) vs(16.35±3.09)μmol·L^(-1),respectively,which were lower than before treatment((27.04±3.68)pg·mL^(-1) vs(27.61±3.54)pg·mL^(-1),(22.88±3.84)μmol·L^(-1) vs(23.14±3.62)μmol·L^(-1)),and the serum levels of NSE and Hcy in the observation group were lower than those in the control(t=8.731,6.011,both P<0.05).The scores of Montreal cognitive assessment scale(MOCA)and mini mental state examination(MMSE)in the two groups were(21.28±2.16)points vs(24.35±2.55)points,(21.86±2.53)points vs(25.61±2.28)points,which were higher than those before treatment((19.92±2.64)points vs(19.32±2.06)points,(17.06±1.48)points vs(17.28±1.59)points),respectively.Meanwhile,the MMSE and MOCA scores in the observation group were higher than those in the control(t=8.529,7.19,both P<0.05).The total effective rate of the observation group was 96.67%(58/60),which was higher than the control’s 81.67%(49/60)(χ^(2)=6.988,P=0.008).The incidence of adverse reactions in the observation gr

关 键 词：氢溴酸加兰他敏 脑卒中 认知功能障碍 同型半胱氨酸 精神状态 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]