目的 对比分析吡拉西坦与奥拉西坦对老年脑出血后认知功能障碍的治疗效果。方法 选择2012年1月~2015年12月在铜川市人民医院进行诊治的老年脑出血患者82例，按照治疗药物的不同分为吡拉西坦组和奥拉西坦组，分别采用吡拉西坦和奥拉西坦进行治疗。比较两组治疗前后的蒙特利尔认知评估量表（MoCA）、简易精神状态检查量表（MMSE）和日常生活能力量表（ADL）评分，以及治疗1、3、6个月后的神经元特异烯醇化酶水平和认知功能改善情况。结果 治疗后，两组的MoCA、MMSE、ADL评分均明显改善（P<0.05），且奥拉西坦组明显优于吡拉西坦组（P<0.05）；与治疗1个月相比，两组治疗6个月的MoCA、MMSE、ADL显效率及总有效率均明显升高（P<0.05），且奥拉西坦组明显优于吡拉西坦组（P<0.05）；两组治疗1、3、6个月后的神经元特异烯醇化酶水平均较治疗前明显降低（P<0.05），且奥拉西坦组在治疗3、6个月的神经元特异烯醇化酶水平明显低于吡拉西坦组（P<0.05）；两组的不良反应发生率相比无明显差异。结论 奥拉西坦改善老年脑出血后认知功能障碍的效果较吡拉西坦更佳，且疗效随着用药时间的延长而增加，并能降低神经元特异烯醇化酶水平，具有较高的临床应用价值。

Objective To compare the effects of piracetam and oxiracetam on elderly cognitive dysfunction after cerebral hemorrhage.Methods Elderly patients (82 cases) with cerebral hemorrhage treated in Tongchuan People's Hospital from January 2012 to December 2015 were selected and divided into two groups according to the different treatment drugs. Two groups were treated by oxiracetam and piracetam respectively. The Montreal cognitive assessment scale (MoCA), simple mental state examination (MMSE), and daily life ability scale (ADL) score of the two groups before and after treatment were compared. The neuron-specific enolase levels and cognitive function after treatment of 1, 3, and 6 months were also compared.Results After treatment, MoCA, MMSE, and ADL scores of two groups were significantly improved (P<0.05), and oxiracetam group were significantly better than piracetam group (P<0.05). After treatment 6 months, MoCA, MMSE, ADL effective and total effective rate of the two groups were significantly higher (P<0.05), and oxiracetam group were significantly better than those of piracetam group (P<0.05). After treatment for 1, 3, and 6 months, the neuron-specific enolase levels were significantly lower than those before treatment (P<0.05), and in the treatment of 3 and 6 months, oxiracetam group were significantly lower than piracetam group (P<0.05). The incidence of adverse reactions had no significant difference.Conclusion Oxiracetam can improve the elderly cognitive dysfunction after cerebral hemorrhage, the curative effect was increased with the prolonging of the time, and can reduce the neuron-specific enolase levels, which has high clinical value.