中国全科医学 ›› 2018, Vol. 21 ›› Issue (21): 2566-2570.DOI: 10.3969/j.issn.1007-9572.2018.00.185

所属专题: 神经退行性病变最新文章合集

• 专题研究 • 上一篇    下一篇

三种疗法对卒中后非痴呆认知功能障碍患者颅内血流的影响

米小昆,王娇兰,崔鹏,刘青蕊,韩颖*   

  1. 050011河北省石家庄市,河北医科大学第四医院神经内科
    *通信作者:韩颖,教授;E-mail:hanying9@139.com
  • 出版日期:2018-07-20 发布日期:2018-07-20
  • 基金资助:
    基金项目:河北省科技厅科技支撑计划项目(12277730)

Effects of Three Therapies on Cerebral Hemodynamics in Patients with Non-dementia Cognitive Impairment after Stroke

  1. Department of Neurology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China
    *Corresponding author:HAN Ying,Professor;E-mail:hanying9@139.com
  • Published:2018-07-20 Online:2018-07-20

摘要: 目的 观察三种疗法治疗卒中后非痴呆认知功能障碍(PSCI-ND)患者颅内血流的变化。方法 选取2010年2月—2016年10月就诊于河北医科大学第四医院神经内科的PSCI-ND患者99例,随机分为电刺激小脑顶核(FNS)组32例、奥拉西坦组32例、尼莫地平组35例。在常规药物治疗的基础上,FNS组给予FNS治疗,奥拉西坦组给予口服奥拉西坦治疗,尼莫地平组给予口服尼莫地平治疗。3组治疗前后均行经颅多普勒(TCD)检查,检测并比较各动脉〔大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、椎动脉颅内段(VA)〕的平均血流速度(MFV),观察不良反应发生情况。结果 治疗后FNS组MCA的MFV高于奥拉西坦组、尼莫地平组(P<0.05);治疗后奥拉西坦组MCA的MFV与尼莫地平组比较,差异无统计学意义(P>0.05);治疗后奥拉西坦组ACA、PCA、VA的MFV低于FNS组、尼莫地平组(P<0.05);治疗后FNS组ACA的MFV高于尼莫地平组(P<0.05)。治疗后FNS组、尼莫地平组各动脉的MFV高于治疗前(P<0.05)。奥拉西坦组各动脉的MFV治疗前、后比较,差异无统计学意义(P>0.05)。3组不良反应发生率比较,差异无统计学意义(χ2=0.730,P>0.05)。结论 FNS、尼莫地平均能够改善PSCI-ND患者脑血供,而奥拉西坦对脑血流无影响。

关键词: 卒中, 认知障碍, 血流动力学, 治疗结果

Abstract: Objective To observe changes in intracranial blood flow in response to three different treatment regimens for non-dementia cognitive impairment(PSCI-ND) after stroke.Methods The study cohort included 99 patients with PSCI-ND who were admitted to the Department of Neurology of the Fourth Hospital of Hebei Medical University from February 2010 to October 2016 and randomly divided into one of three groups on the basis of conventional drug therapy:a cerebellar fastigial nucleus(FNS) group (n=32),an oxiracetam group(n=32),and a nimodipine group(n=35).Transcranial Doppler ultrasonography was performed before and after treatment in all three groups to measure and compare the average blood flow velocity(MFV) of the middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA),and intracranial vertebral artery(IVA) to observe the occurrence of adverse reactions.Results After treatment,the MFV of the MCA in the FNS group was higher than that of the oxiracetam and nimodipine groups(P<0.05).After treatment,the MFV of the MCA in the oxiracetam group was not significantly different from that of the nimodipine group(P>0.05).The MFV of the ACA,PCA,and IVA in the oxiracetam group after treatment was lower than in the FNS and nimodipine groups(P<0.05).After treatment,the MFV of the ACA was higher in the FNS group than in nimodipine group(P<0.05).The MFV of the arteries in the FNS and nimodipine groups after treatment was higher than that before treatment(P<0.05).There was no significant difference in the MFV of each artery before and after treatment in the oxiracetam group(P>0.05).There was no significant difference in the incidence of adverse reactions among the three groups(χ2=0.730,P>0.05).Conclusion FNS and nimodipine generally improved cerebral blood supply in patients with PSCI-ND,but not oxiracetam.

Key words: Stroke, Cognition disorders, Hemodynamics, Treatment outcome