摘要
目的探讨丁苯酞注射液对伴有认知障碍的脑梗死急性期患者脑血流灌注和认知功能的影响。方法将自2016年9月至2017年9月在昆明医科大学附属延安医院神经内科住院的80例伴有认知障碍的脑梗死急性期患者依据患者意愿分为对照组（n=40）和观察组（n=40），对照组采用常规治疗方法，观察组在对照组治疗方法基础上联合丁苯酞注射液治疗，疗程14d。治疗前后行磁共振动态磁敏感对比增强灌注加权成像（DSC-PWI）检查测量缺血区脑血流灌注参数．采用蒙特利尔认知评估量表（MoCA）评估认知功能。结果治疗后观察组相对脑血流量（rCBF）、相对脑血容量（rCBV）较治疗前明显提高，相对平均通过时问（rMTT）和相对达峰时间rTTP）较治疗前明显降低，差异均有统计学意义（P〈0．051。治疗后观察组MoCA量表各亚项评分和总评分较治疗前明显提高，差异均有统计学意义（P〈0．05）。观察组治疗前后rCBV、rCBF增加值与MoCA量表总评分增加值呈正相关关系（r=0．474，P=-0．013；r=0．282，P=0．027），rMTT、rTTP降低值与MoCA量表总评分增加值呈负相关关系（r=0．294，P=-0．021；r=-0．382，P=0．019）。结论丁苯酞注射液可提高伴有认知障碍的脑梗死急性期患者缺血区脑血流灌注水平并改善其认知功能。
Objective To investigate the effects of butylphthalide injection on cerebral blood
flow (CBF)perfusion and cognitive function in patients with acute cerebral infarction accompanied by
cogn itive disorder． M ethods From September 2016 to September 2017．80 patients with acute
cerebral infarction and cogn itive impairment were admitted to the Department of Neurology， Yan’an
Hospital of Kunming Medical University．They were assigned to an observation group (n 40) and a
control group (n=40)． The control group received conventional treatment while the observation group
received butylphthalide injection in addition to conventional treatment．The treatment lasted for 14 days
for both groups．Before and after treatment，dynamic susceptibility contrast—enhanced perfusion-weighted
imaging Fdsc—Pwi) was used to measure the CBF parameters in the cerebral ischemic region， and
Mon^eal Cognitive Assessment (MoCA) was used to evaluate the changes in cognitive function．
Results After treatm ent． Rcbf and Rcbv increased significantly and Rmtt and r1’TP decreased
significantly in the observation group(尸l<0．05)．After treatm ent，there were significant improvements in MoCA subscores and total score in the observation group (Pl<0．05)． In the observation group， the
post-treatment increases in Rcbv and Rcbf were positively correlated with increased MoCA total score
(r=O．474， P=0．013； r=0．282， P=0．027)， and the post-treatm ent decreases in Rmtt and Rttp were
negatively correlated with increased MoCA total score (产一0．294， 0．021； r=-0．382， 0．019)．
Conclusion Butylphthalide injection can safely improve CBF perfusion in the focal region and
cognitive function in patients with acute cerebral infarction，with no obvious adverse reactions．
作者
邬刚
李建辉
战丽萍
马鹏程
安明顺
Wu Gang;Li Jianhui;Zhan Liping;Ma Pengcheng;An Mingshun(Department of Neurology, Yan＇an Hospital Affiliated to Kunming Medical University, Kunming 650051, China;Department of Radialogy, Yan＇an Hospital Affiliated to Kunming Medical University, Kunming 650051, China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2018年第5期484-490,共7页
Chinese Journal of Neuromedicine
基金
昆明医科大学附属延安医院院内课题（yyky017-032）
关键词
丁苯酞注射液
脑梗死
急性期
认知障碍
脑血流灌注
Butylphthalide
Cerebral infarction；Acute stage
Cognitive dysfunction
Cerebral blood flow perfusion
