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目的观察丁苯酞治疗急性脑梗死患者轻度认知功能障碍的效果。方法选择2015年1月—2016年12月收治的急性脑梗死患者120例,随机分为观察组与对照组,每组60例。对照组采用常规治疗,包括抗血小板聚集、调脂、营养神经、改善循环、控制颅压、血压、血糖等对症支持治疗。观察组在对照组基础上加丁苯酞注射液100 ml静脉滴注,滴注时间>50 min,两次用药间隔不少于6 h。两组均连续治疗14 d。对比两组疗效;分别于治疗前及治疗14 d依据美国国立卫生研究院卒中量表(NIHSS)评分评价两组神经功能缺损程度,蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)及简易智能状态检查(mini mental state examination,MMSE)评分评价两组认知功能。观察两组治疗期间的不良反应。NIHSS、MoCA及MMSE评分比较采用t检验,总有效率比较采用χ~2检验。P<0.05为差异有统计学意义。结果观察组总有效率(95.00%)高于对照组(63.33%),比较差异有统计学意义(P<0.05)。治疗后两组NIHSS、Mo CA及MMSE评分[观察组:(7.05±1.16)、(21.04±4.46)、(24.90±5.54)分,对照组:(12.43±2.08)、(17.83±3.19)、(20.13±4.09)分]均较治疗前[观察组:(17.80±5.54)、(16.43±5.57)、(17.49±6.13)分,对照组:(17.09±6.37)、(16.30±6.01)、(17.81±6.60)分]改善(均P<0.05),但观察组改善更明显(均P<0.05)。治疗过程中两组均未发生明显不良反应,治疗前后肝肾功能、血尿常规均无明显变化,无一例发生颅内出血和消化道出血。结论丁苯酞可有效改善急性脑梗死患者的轻度认知功能障碍。
Objective To observe the effect of butylphthalide on mild cognitive impairment in patients with acute cerebral infarction. Methods 120 patients with acute cerebral infarction who were admitted from January 2015 to December 2016 were randomly divided into observation group and control group with 60 cases in each group. Control group with conventional treatment, including anti-platelet aggregation, lipid-lowering, nutritional nerves, improve circulation, control of intracranial pressure, blood pressure, blood sugar and other symptomatic and supportive treatment. The observation group was given drip infusion of butylphthalide 100 ml on the basis of the control group, the drip time was> 50 min, and the interval of two doses was not less than 6 h. Both groups were treated for 14 days. The levels of neurological impairment, Montreal Cognitive Assessment (MoCA), and simple intelligence were evaluated before and 14 days after treatment according to the National Institutes of Health Stroke Scale (NIHSS) score. The mini mental state examination (MMSE) score assessed cognitive function in both groups. Adverse reactions during the two groups were observed. NIHSS, MoCA and MMSE score using t test, the total efficiency was compared using χ ~ 2 test. P <0.05 for the difference was statistically significant. Results The total effective rate (95.00%) in the observation group was higher than that in the control group (63.33%), the difference was statistically significant (P <0.05). After treatment, NIHSS, MoCA and MMSE score of the two groups [observation group: (7.05 ± 1.16), (21.04 ± 4.46), (24.90 ± 5.54), control group: (12.43 ± 2.08), (17.83 ± 3.19) 20.13 ± 4.09) were significantly higher than those before treatment [observation group: (17.80 ± 5.54), (16.43 ± 5.57), (17.49 ± 6.13) points, control group: (17.09 ± 6.37), (16.30 ± 6.01), (17.81 ± 6.60)] (all P <0.05), but the improvement in the observation group was more obvious (all P <0.05). There was no significant adverse reaction in both groups during the course of treatment. There was no significant change in liver and kidney function and hematuria before and after treatment, and no one had intracranial hemorrhage and gastrointestinal bleeding. Conclusion Butylphthalide can effectively improve mild cognitive impairment in patients with acute cerebral infarction.