摘要
目的研究认知康复训练与盐酸多奈哌齐对脑卒中后认知障碍(post-stroke cognitive impairment,PSCI)患者事件相关电位P300的影响。方法筛选44例脑卒中后认知障碍患者作为研究对象。随机分成药物组(24例)和对照组(20例)。药物组除口服盐酸多奈哌齐外,2组患者均给予正规认知康复训练。治疗前和治疗4周后进行蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)评定、事件相关电位(event-related potential,ERP)P300检查。结果2组治疗前后相比,MoCA总分均明显改善(P<0.05);同时P300潜伏期缩短(P<0.01),波幅增高(P<0.05);与对照组相比,药物组治疗后MoCA总分改善差异有统计学意义(P<0.05);进一步子项比较,视空间及执行功能明显改善(P<0.01),注意及延迟记忆改善(P<0.05)。命名、语言、抽象及定向子项评分差异无统计学意义(P>0.05)。P300潜伏期明显缩短(P<0.01),波幅提高(P<0.01)。结论较单纯认知康复训练相比,与多奈哌齐联合治疗可显著改善脑卒中患者的认知障碍,尤其改善视空间与执行功能、注意及记忆功能。
Objective To observe the effects of cognitive rehabilitation combined with donepezil on P300 potential of post- stroke cognitive impairment（PSCI）. Methods Forty four patients with PSCI were randomly divided into medicine group （24 cases） and control group （20 cases）. All participants were adults （28 male and 16 female; mean age 63.58± 10.37）. Patients in both groups were given cognitive rehabilitation training for 1 month, and the patients in medicine group were treated with donepezil 5mg/d for 1 month in addition. All patients with PSCI were assessed by Montreal cognitive assessment scale （MoCA）, auditory e vent-related potentials P300 before and after 1 month treatments. Results After 1 month treatment,both groups obtained remark- able higher scores in MoCA than those before treatments （P〈0.05）. Compared to control group, the increase of MoCA improve ment in medicine group was much more imposing, especially in vision orientation and executive function （P%0.01） and concentra- tion and delayed memory （P＊~0.05）. P300 latency of control group was shorten than before（P〈0.05）. Compared with the two group after treatment, P300 latency in medicine group was shorten （P〈0.05）, and P300 amplitude was obviously higher （P〈0.01）, which was statistically significant. Conclusion Compared with cognitive rehabilitation only, cognitive rehabilitation combined with donepezil has better effect in patients with PSCI.
出处
《中国实用神经疾病杂志》
2017年第23期24-28,共5页
Chinese Journal of Practical Nervous Diseases
基金
上海市残联课题(YZ2015002)
