2022 年第 4 期 第 17 卷

多奈哌齐与尼莫地平对老年脑卒中后认知功能障碍患者认知能力和日常生活活动能力的影响比较

Effects of donepezil and nimodipine on cognitive ability and activity of daily living in elderly patients with post-stroke cognitive impairment

作者：李倩倩于华吴咏静张慧儒

英文作者：Li Qianqian Yu Hua Wu Yongjing Zhang Huiru

单位：河北省石家庄市人民医院老年病科二病区，石家庄050000

英文单位：Department of Geriatric the Second Ward Shijiazhuang People′s Hospital Hebei Province Shijiazhuang 050000 China

关键词：脑卒中后认知功能障碍；多奈哌齐；日常生活活动能力

英文关键词：Post-strokecognitiveimpairment；Donepezil;Activityofdailyliving

• 摘要：

• 目的 探讨多奈哌齐与尼莫地平对老年脑卒中后认知功能障碍（PSCI）患者认知能力和日常生活活动能力（ADL）的影响。方法 选取河北省石家庄市人民医院2019年8月至2021年6月收治的PSCI患者82例，应用随机数字表法分为2组，各41例。对照组在常规对症治疗基础上给予尼莫地平口服治疗，观察组在常规对症治疗基础上给予多奈哌齐口服治疗，2组均持续治疗12周。比较2组治疗前后认知能力、ADL和智力水平的变化以及治疗过程中的不良反应发生率。结果 治疗前，2组蒙特利尔认知评估量表(MoCA)、ADL量表和长谷川痴呆量表(HDS-R)评分比较差异均无统计学意义（均P＞0.05），治疗12周后，2组MoCA、ADL和HDS-R评分均高于治疗前，且观察组均高于对照组［（26±5）分比（22±5）分、（68±6）分比（57±6）分、（25.5±1.6）分比（21.4±1.2）分］（均P＜0.05）。观察组治疗期间不良反应发生率与对照组比较差异无统计学意义［7.3%(3/41)比12.2%（5/41）］（P=0.709）。结论 多奈哌齐对老年PSCI患者认知功能、ADL和智力水平的改善作用优于尼莫地平，且不增加药物相关不良反应。

• Objective To investigate the effects of donepezil and nimodipine on cognitive ability and activity of daily living (ADL) in elderly patients with post-stroke cognitive impairment (PSCI). Methods Total 82 patients with PSCI admitted to Shijiazhuang People′s Hospital, Hebei Province from August 2019 to June 2021 were enrolled.  They were randomly divided into two groups with 41 cases in each group. The control group was treated with nimodipine orally on the basis of routine symptomatic treatment, and the observation group was treated with donepezil orally on the basis of routine symptomatic treatment. Both groups were treated for 12 weeks. The changes of cognitive ability, ADL and intelligence level, and the incidence of adverse reactions were compared between the two groups before and after treatment. Results Before treatment, there were no significant differences in the scores of Montreal Cognitive Assessment Scale (MoCA), ADL scale and Hasegawa Dementia Scale (HDS-R) between the two groups (all P>0.05). After 12 weeks of treatment, the scores of MoCA， ADL scale and HDS-R in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group ［(26±5) vs (22±5), (68±6) vs (57±6), (25.5±1.6) vs (21.4±1.2)］(all P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group ［7.3%(3/41) vs 12.2%(5/41)］(P=0.709). Conclusion Donepezil is better than nimodipine to improve cognitive function, ADL and intelligence level in elderly patients with PSCI, and does not increase drug-related adverse reactions.