摘要
背景卒中后非痴呆性认知障碍(PSCI-ND)主要表现为多个认知领域障碍。有研究表明,脑卒中后6 个月、1 年的患者认知功能障碍改善率则分别为 19.6%、13.1%。不同方法对不同认知领域的治疗作用不同,针对不同患者应选择不同的治疗方法,从而为患者提供更加精准的治疗措施。目的观察电刺激小脑顶核(FNS)、奥拉西坦、尼莫地平对 PSCI-ND 患者不同认知领域的影响。方法选取 2013 年 1 月 2017 年 9 月河北医科大学第四医院神经内科收治的 PSCI-ND 患者 96 例,根据随机数字分组法将患者分为 FNS 组、奥拉西坦组、尼莫地平组,每组各 32 例。在常规治疗基础上,FNS 组患者行 FNS,1 次/d,疗程 30 d;奥拉西坦组给予奥拉西坦口服,0.8 g/次,3 次/d,疗程30 d;尼莫地平组给予尼莫地平口服,30 mg/次,3 次/d,疗程 30 d。同时监测各种不良反应。并观察治疗前后患者蒙特利尔认知功能评估量表(MoCA)总分及亚项评分的变化。结果治疗后,3 组注意力、语言能力、抽象能力、记忆力、定向力评分比较,差异均无统计学意义(P>0.05);3 组视空间与执行功能评分、MoCA 总分比较,差异均有统计学意义(P<0.05);其中,奥拉西坦组和尼莫地平组视空间与执行功能评分、MoCA 总分均低于 FNS 组,尼莫地平组 MoCA 总分低于奥拉西坦组(P<0.05)。FNS 组治疗后视空间与执行功能、注意力、语言能力、记忆力、定向力评分及 MoCA 总分均高于治疗前;奥拉西坦组治疗后视空间与执行功能、注意力、语言能力、记忆力评分及 MoCA 总分均高于治疗前;尼莫地平组治疗后语言能力及记忆力评分均高于治疗前(P<0.05)。 FNS 组不良反应发生率为 6.2%(2/32),奥拉西坦组为 9.4%(3/32),尼莫地平组为 9.4%(3/32),3 组不良反应发生率比较,差异无统计学意义(P=1.000)。结论 FNS、奥拉西坦更能提高 PSCI-ND 患者的认知功能,FNS 对视空间与执行功能、注意力及
Background Post-stroke cognitive impairment with no dementia(PSCI-ND) mainly is mainly manifested by multiple cognitive impairment.Studies have shown that 6 months,1 year after stroke in patients with cognitive dysfunction improvement rate are 19.6%,13.1% respectively. Different methods have different therapeutic effects in different cognitive fields.Different treatment methods should be chosen for different patients.Objective To assess the effects of cerebellar fastigial nucleus electrical stimulation(FNS),oxiracetam and nimodipine on different cognitive domains of patients with PSCI-ND.Methods A total of 96 patients with PSCI-ND admitted to the Department of Neurology,the Fourth Hospital of Hebei Medical University from January 2013 to September 2017 were randomly divided into FNS group,oxiracetam group and nimodipine group,each with 32 cases.With conventional treatment,the FNS group was treated with FNS,1 time/d,30 days of treatment;oxiracetam group was given oxiracetam orally with 0.8 g,3 times/d,30 days of treatment,and nimodipine group was treated with nimodipine with 30 mg,3 times/d,30 days of treatment.Various adverse reactions were monitored and total score and sub-item score changes of Montreal Cognitive Assessment (MoCA) before and after treatment of 3 groups were observed. Results After treatment,there were no significant differences in scores of attention,language ability,abstract reasoning ability,memory,and orientation ability among three groups (P>0.05).There were significant differences in visual space, execution ability and total score of MoCA among three groups (P<0.05).Among them,scores of visual space and executive ability and MoCA total score of oxiracetam group and nimodipine group were lower than those of FNS group,and MoCA total score of nimodipine group was lower than that of oxiracetam group (P<0.05).After treatment,scores of postoperative visual space and execution ability,attention ability,language ability,memory,orientation ability and MoCA total score in FNS group were higher;scores
作者
米小昆
史健
刘辉
王娇兰
崔鹏
韩颖
MI Xiaokun;SHI Jian;LIU Hui;WANG Jiaolan;CUI Peng;HAN Ying(Department of Neurology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《中国全科医学》
CAS
北大核心
2019年第11期1293-1297,共5页
Chinese General Practice
基金
河北省重点研发计划项目( 172777227)
河北省卫生厅项目( 20180502 )
