论文部分内容阅读
目的：探讨氨基酸受体拮抗剂对老年脑卒中后引发血管性痴呆患者学习记忆的影响。方法选取2014年8月～2015年12月浙江省立同德医院老年科收治的脑卒中后引发血管性痴呆老年（≥65岁）患者68例，按随机数字表法分为对照组和研究组，分别为34例，对照组在常规治疗基础上给予复方海蛇胶囊治疗，3粒／次，3次／天；研究组在常规治疗基础上加用美金刚治疗，前3周5～15 mg／d，第4周开始20 mg／d，2组均治疗6个月。于治疗前后测定脑脊液、血液学及临床相应指标。结果与治疗前比较，2组治疗后脑脊液神经肽物质生长抑素（ somatostatin，SS）、精氨酸血管加压素（ arginine vasopressin ，AVP）含量升高，简易精神状态检查量表（Mini－Mental State Examination，MMSE）、修订的长谷川智能量表（Hasegawa Dementia Scale，HDS－R）评分升高，日常生活能力量表（ Activity of Daily Living Scale ，ADL）评分降低，潜伏期P300降低，波幅P300升高，脑源性神经营养因子（ Brain derived neurotrophic factor，BDNF）、血管内皮生长因子（vascular endothelial growth factor ，VEGF）含量升高，差异均具有统计学意义（P＜0．05）；与对照组比较，研究组治疗后脑脊液SS、AVP含量较高，MMSE、HDS－R评分较高，ADL评分较低，潜伏期P300较低，波幅P300较高，VEGF、BDNF含量较高，差异均具有统计学意义（P＜0．05）。结论氨基酸受体拮抗剂能提高脑卒中后引发血管性痴呆老年患者的学习记忆能力，改善脑脊液和血液学指标。“,”Objective To investigate the effects of amino acid receptor antagonists in the treatment of vascular dementia after cerebral apoplexy in elder in the function of study and memory.Methods 68 elder patients(≥65 years older) with vascular dementia caused by stroke from August 2014 to December 2015 in tongde hospital of zhejiang province were selected and randomly divided into study group and control group , 34 cases in each group.The control group received the convention treatment and combined with compound haishe capsule three pills each time , three times/day,the study group received convention treatment and combined with memantine three weeks before 5-15 mg/day,fourth week 20 mg/day,two groups were treated for six months.Cerebrospinal fluid,hematological and clinical indexes were compared before and after treatment.Results Compared with before treatment, levels of SS and AVP of cerebrospinal fluid in two groups after treatment increased,levels of MMSE and HDS-R increased,scores of ADL decreased, levels of P300 in latency decreased and levels of P300 in amplitude increased,levels of VEGF and BDNF increased,the differences were statistically significant (P<0.05).Compared with the control group,levels of SS and AVP in cerebrospinal fluid in the study group were higher,levels of MMSE and HDS-R were higher,scores of ADL were lower,levels of P300 in latency were lower and levels of P300 in amplitude were higher,and levels of VEGF and BDNF were higher,the differences were statistically significant (P<0.05).Conclusion Amino acid receptor antagonists can increase the ability of learning and memory in patients with senile vascular dementia after stroke, and it can improve the cerebrospinal fluid and blood indexes.