文章摘要

长春西汀对颅内动脉狭窄支架置入术后患者多维认知功能的保护作用

作者: 1程仙送, 2李欢欢, 1刘军, 1王晓辉
1 陕西省人民医院神经内一科,西安 710068
2 空军军医大学唐都医院神经内科,西安 710038
通讯: 李欢欢 Email: huanhuan19840620@163.com
DOI: 10.3978/j.issn.2095-6959.2021.06.011

摘要

目的:探讨长春西汀对症状性颅内动脉狭窄支架置入术后患者的多维认知功能保护作用。方法:选取2016年6月至2019年6月陕西省人民医院神经内科住院确诊的142例症状性颅内动脉狭窄支架置入术后患者,将患者分为对照组(n=71,采用传统治疗)和实验组(n=71,在对照组基础上加用长春西汀)。收集两组一般临床资料和神经功能恢复情况[改良Rankin评分量表(Modified Rankin Scale,mRS)评分和美国国立卫生院神经功能缺损评分(National Institute of Health Stroke Scale,NIHSS)评分]。治疗后1个月首先采用简易智能精神状态量表(Mini-Mental State Examination,MMSE)、中文版蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评估两组患者的一般认知功能,后采用多维心理评估系统评估患者的多维认知功能。结果:两组一般临床资料差异无统计学意义(P>0.05)。实验组mRS评分和NIHSS评分均较对照组显著改善,神经功能评分均较对照组明显减低(均P<0.05)。两组MMSE和MoCA差异无统计学意义(P>0.05)。进一步亚项目分析提示实验组的记忆力、定向力、注意力、执行能力、命名能力、计算力和抽象思维能力评分较对照组明显改善(均P<0.05)。实验组在数字序列推理实验、简单计算测验、词语即刻回忆、图片即刻会议、言语工作记忆(正向,反向)、空间工作记忆、词语辨析和执行功能等方面较对照组明显改善(均P<0.05)。结论:长春西汀可以有效降低患者的多维认知功能损害。
关键词: 长春西汀;症状性颅内动脉狭窄;支架置入术后;多维认知

Protective effect of vinpocetine on multidimensional cognitive function in patients with intracranial artery stenosis after stent implantation

Authors: 1CHENG Xiansong, 2LI Huanhuan, 1LIU Ju, 1WANG Xiaohui
1 First Department of Neurology, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
2 Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi’an 710038, China

CorrespondingAuthor: LI Huanhuan Email: huanhuan19840620@163.com

DOI: 10.3978/j.issn.2095-6959.2021.06.011

Abstract

Objective: To explore the protective effect of vinpocetine on multiple cognitive functions in patients with symptomatic intracranial artery stenosis. Methods: A total of 142 patients with symptomatic intracranial artery stenosis confirmed in our Neurology Department from June 2016 to June 2019 were collected and divided into a control group (n=71, traditional treatment) and an experimental group (n=71, plus vinpocetine based on treatment of the control group). The general clinical data of the 2 groups were collected, and neurological function recovery [Modified Rankin Scale (mRS) and National Institute of Health stroke scale (NIHSS) scores] of the 2 groups before and after the treatment were analyzed. One month after the treatment, the general cognitive function of the two groups was evaluated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and then the multidimensional cognitive function was evaluated by the multidimensional psychological evaluation system. Results: There was no significant difference in general clinical data between the two groups. The scores of mRS and NIHSS in the experimental group were significantly higher, but the scores of neurological function were significantly lower than those in the control group (both P<0.05). The results of MMSE and MoCA showed that there was no significant difference in the total score between the two groups, but further sub-item analysis suggested that the memory, orientation, attention ,executive ability, naming ability, computational ability and abstract thinking ability in the experimental group significantly improved compared with those in the control group (both P<0.05). The digit sequence reasoning experiment, simple calculation test, word instant recall, picture instant meeting, speech working memory (forward, reverse), spatial working memory, word discrimination and executive function improved significantly in the experiment group than those in the control group (all P<0.05). Conclusion: Vinpocetine can effectively reduce the multi-dimensional cognitive impairment of patients.
Keywords: vinpocetine; symptomatic intracranial artery stenosis; post stent implantation; multi-dimensional cognition