目的 比较奥拉西坦和吡拉西坦治疗老年脑出血后认知功能障碍的临床疗效和安全性。方法 上海中冶职工医院2012年2月—2013年12月收治的老年脑出血患者104例，随机分为对照组和治疗组，每组各52例。对照组口服吡拉西坦片，4片/次，3次/d。治疗组口服奥拉西坦胶囊，2粒/次，3次/d。两组均持续治疗6个月。分别于治疗前后采用蒙特利尔认知评估（MoCA）量表、简易智能精神状态检查（MMSE）量表和日常生活活动（ADL）量表进行认知功能评定。结果 治疗后，两组MoCA、MMSE量表的项目评分均较治疗前显著提高，同组治疗前后差异有统计学意义（P<0.05）；治疗后，治疗组MoCA量表中执行功能、计算评分高于对照组；治疗组MMSE量表中即刻回忆力、注意计算力、语言能力、总分均高于对照组，两组比较差异有统计学意义（P<0.05）。两组不良反应发生率比较差异无统计学意义。结论 奥拉西坦较吡拉西坦可更好的改善老年脑出血后患者的认知功能障碍，且不良反应较少，具有良好的临床疗效和安全性。

Objective To compare the clinical efficacy and safety between oxiracetam and piracetam in the treatment of elderly cognitive dysfunction after cerebral hemorrhage. Methods Elderly cerebral hemorrhage patients (104 cases) who came to Zhongye Worker Hospital in Shanghai from February 2012 to December 2013 were randomly divided into control and treatment groups, and there were 52 cases in each group. The patients in the control group were po administered with Piracetam Tablets, 4 tablets/time, three times daily. The patients in the treatment group were po administered with Oxiracetam Capsules, 2 capsules/time, three times daily. The patients in the two groups were treated for 6 months. Cognitive function was assessed by Montreal cognitive assessment (MoCA) scale, minimum mental state examination (MMSE) activities and daily living (ADL) before and after the treatment. Results After the treatment, project scores of MoCA and MMSE scales were significantly improved, and the difference was statistically significant before and after the treatment in the same group (P < 0.05). After the treatment, the executive function and calculation scores of MoCA scale in the treatment group were higher than those in the control group, while immediate recall force, computing power, language ability, and total scores of MMSE scale were higher than those in the control group, and there were differences between the two groups (P < 0.05). There was no difference on the incidence of adverse drug reactions (ADR) between the two groups. Conclusion Compared with piracetam, oxiracetam can effectively improve the cognitive dysfunction of elderly patients after cerebral hemorrhage, and have good clinical efficacy and safety with less ADR.

军队“十二五”军队医疗机构制剂标准提高专项课题（13ZJZ17-2）