目的 研究美金刚联合茴拉西坦对血管性痴呆的疗效及对血清雌二醇（E2）、内皮生长因子（VEGF）水平的影响。方法 选择2016年9月-2018年07月在许昌市立医院进行诊治的350例血管性痴呆患者，随机分为两组。对照组服用茴拉西坦，每次0.2 g，每天3次；观察组联合服用美金刚5 mg/d，每周将给药剂量递增5 mg，到第4周的20 mg/d时维持给药剂量。两组均治疗6个月。比较两组的认知功能MMSE评分、病理行为评分和血清E2、VEGF水平。结果 观察组的有效率（85.14%）明显高于对照组（64.57%），差异有统计学意义（P<0.05）。两组治疗后的认知功能MMSE评分均明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显高于对照组，差异有统计学意义（P<0.05）。两组治疗后的幻觉、偏执妄想、行为紊乱、昼夜节律紊乱、攻击行为、焦虑恐惧以及情感障碍评分值均明显降低，同组治疗前后比较差异有统计学意义（P<0.05），且观察组明显低于对照组，差异有统计学意义（P<0.05）。两组治疗后的血清E2、VEGF水平均明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显高于对照组，差异有统计学意义（P<0.05）。结论 美金刚联合茴拉西坦对血管性痴呆患者具有确切的疗效，其作用机制可能与提高血清E2、VEGF水平相关。

Objective To investigate the clinical effect of aniracetam combined with memantine on serum E2 and VEGF levels in patients with vascular dementia. Methods Selected 350 cases of patients with vascular dementia who were treated in our hospital from September 2016 to July 2018, divided into two groups randomly. The control group was given Ra Laci Staw and the observation group was treated with memantine. Cognitive function MMSE score, pathological behavior score, serum E2 and VEGF levels were compared between the two groups. Results The effective rate of the observation group was significantly higher than control group (P<0.05). The cognitive function MMSE scores of the two groups increased significantly after treatment (P<0.05), and the observation group was more significant (P<0.05). The scores of hallucinations, paranoia, behavior disorder, circadian rhythm disorder, attack behavior, anxiety and fear, and affective disorder scores in the two groups were significantly decreased (P<0.05), and the observation group was more obvious (P<0.05). The serum E2 and VEGF levels of the two groups increased significantly (P<0.05), and the observation group was more significant (P<0.05). Conclusion Aniracetam combined with memantine has definite curative effect on vascular dementia patients, and its mechanism may be related to the elevation of serum E2 and VEGF levels.