目的 分析艾地苯醌联合倍他司汀治疗脑梗死后认知功能障碍的临床疗效。方法 选取2020年1月-2021年10月长治医学院附属和平医院98例脑梗死后认知功能障碍患者,采用区组随机分组法分为对照组(49例)和治疗组(49例)。对照组口服盐酸倍他司汀片,8 mg/次,3次/d。治疗组在对照组基础上口服艾地苯醌片,30 mg/次,3次/d。两组患者均治疗2个月。观察两组患者临床疗效,比较治疗前后两组患者血液流变学指标血细胞比容(HCT)、纤维蛋白原(FIB)和血小板黏附率(PAR)水平,氧化应激指标超氧化物歧化酶(SOD)和丙二醛(MDA)水平,神经功能指标视锥蛋白样蛋白-1(VILIP-1)、胰岛素样生长因子-1(IGF-1)和脑源性神经营养因子(BDNF)水平。结果 治疗后,治疗组总有效率(95.92%)较对照组(79.59%)明显升高(P<0.05)。治疗1、2个月,两组HCT、FIB、PAR、MDA、VILIP-1水平明显低于治疗前(P<0.05),且治疗2个月时低于治疗1个月(P<0.05);治疗1、2个月,治疗组这些指标低于同期对照组(P<0.05);治疗1、2个月,两组简易智能精神状态量表(MMSE)评分、SOD、IGF-1及BDNF水平高于治疗前(P<0.05),且治疗2个月高于治疗1个月(P<0.05);治疗1、2个月,治疗组这些指标高于同期对照组(P<0.05)。结论 艾地苯醌联合倍他司汀用于脑梗死后认知功能障碍可提高疗效,加快恢复认知功能,促进神经功能、血液流变学改善,抑制氧化应激损伤,安全可靠。

Objective To analyze the effect of idebenone combined with betahistine in treatment of cognitive dysfunction after cerebral infarction. Methods Patients (98 cases) with cognitive dysfunction after cerebral infarction in Heping Hospital Affiliated to Changzhi Medical College from January 2020 to October 2021 were divided into control (49 cases) and treatment (49 cases) group according to block randomization. Patients in the control group were po administered with Betahistine Hydrochloride Tablets, 8 mg/time, three times daily. Patients in the treatment group po administered with Idebenone Tablets on the basis of the control group, 30 mg/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical evaluation was evaluated, and the levels of blood rheological indicators HCT, FIB and PAR, the oxidative stress indexes SOD and MDA levels, the levels of neurological function indicators VILIP-1, IGF-1 and BDNF in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group (95.92%) was significantly higher than 79.59% of the control group (P＜0.05). After 1 and 2 months of treatment, the levels of HCT, FIB, PAR, MDA and VILIP-1 in two groups were significantly lower than those before treatment (P＜0.05), the levels of 2 months after treatment was lower than that at 1 month (P＜0.05), and which in the treatment group was lower than that in the control group (P＜0.05). After treatment for 1 and 2 months, the MMSE scores, SOD, IGF-1 and BDNF in two groups were higher than those before treatment (P＜0.05), and which after the two-month treatment was higher than that after the first month (P＜0.05), and these indexes in the treatment group was higher than the control group (P＜0.05). Conclusion Idebenone combined with betastine in treatment of cognitive impairment after cerebral infarction can improve the therapeutic effect, accelerate the recovery of cognitive function, promote the improvement of neurological function and hemorheology, inhibit oxidative stress injury, and which is safe and reliable.

R971

山西省2020年研究生创新项目(2020SY447)