2023 年第 11 期 第 18 卷

石杉碱甲片联合奥拉西坦胶囊治疗脑梗死后血管性认知功能障碍的临床研究

Clinical research of huperzine A tablets combined with oxiracetam capsules in the treatment of vascular cognitive impairment after cerebral infarction

作者：王晓辉1王乐1常莎1陈红男2崔小丽1

英文作者：Wang Xiaohui1 Wang Le1 Chang Sha1 Chen Hongnan2 Cui Xiaoli1

单位：1陕西省人民医院神经内一科，西安710068；2陕西省人民医院检验科，西安710068

英文单位：1First Department of Neurology Shaanxi Provincial People′s Hospital Xi′an 710068 China; 2Department of Clinical Laboratory Shaanxi Provincial People′s Hospital Xi′an 710068 China

关键词：脑梗死；血管性认知功能障碍；石杉碱甲片；奥拉西坦胶囊

英文关键词：Cerebralinfarction;Vascularcognitiveimpairment;HuperzineAtablets;Oxiracetamcapsules

• 摘要：

• 目的  探讨石杉碱甲片联合奥拉西坦胶囊治疗脑梗死后血管性认知功能障碍（VCI）的临床效果。方法  选取陕西省人民医院2019年6月至2022年6月收治的95例脑梗死后VCI患者，采用随机数字表法将患者分为对照组（47例）和观察组（48例）。对照组给予奥拉西坦胶囊治疗，观察组给予石杉碱甲片联合奥拉西坦胶囊治疗，2组均连续治疗6个月。比较2组治疗前后的蒙特利尔认知评估量表（MoCA）评分、简易智力状态检查量表（MMSE）评分及血清高敏C反应蛋白、肿瘤坏死因子α、白细胞介素6、内皮素1、同型半胱氨酸（Hcy）、一氧化氮水平。比较2组治疗期间不良反应发生率。结果  治疗后2组MoCA评分和MMSE评分均高于治疗前，且观察组均高于对照组（均P<0.05）。治疗后，2组血清内皮素1、Hcy水平均低于治疗前，且观察组均低于对照组；一氧化氮水平均高于治疗前，且观察组高于对照组（均P<0.05）。治疗期间，观察组发生胃肠道不适1例、头晕1例；对照组发生头晕1例；观察组与对照组不良反应发生率比较［4.2%（2/48）比2.1%（1/47）］，差异无统计学意义（χ2=0.366，P=0.545）。结论  石杉碱甲片联合奥拉西坦胶囊治疗脑梗死后VCI的临床疗效较好，有助于提高患者认知功能，其作用可能与抑制炎症反应和改善血管内皮功能有关，具有较好的安全性。

• Objective  To investigate the clinical efficacy of huperzine A tablets combined with oxiracetam capsules in the treatment of vascular cognitive impairment (VCI) after cerebral infarction. Methods  A total of 95 patients with VCI after cerebral infarction admitted to Shaanxi Provincial People′s Hospital from June 2019 to June 2022 were selected. The patients were divided into control group (47 cases) and observation group (48 cases) by random number table method. The control group was treated with oxiracetam capsule, and the observation group was treated with huperzine A tablets combined with oxiracetam capsule. Both groups were treated for 6 months. The Montreal cognitive assessment (MoCA) score, mini-mental state examination (MMSE) score and serum levels of high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-6, endothelin-1, homocysteine (Hcy) and nitric oxide were compared between the two groups before and after treatment. The incidence of adverse reactions during treatment was compared between the two groups. Results  After treatment, the MoCA and MMSE scores in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P<0.05). After treatment, the levels of serum endothelin-1 and Hcy in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group; the level of nitric oxide was higher than that before treatment, and that in the observation group was higher than that in the control group (all P<0.05). During the treatment, there were 1 case of gastrointestinal discomfort and 1 case of dizziness in the observation group, and there was 1 case of dizziness in the control group. There was no significant difference in the incidence of adverse reactions between the observation group and the control group ［4.2%(2/48) vs 2.1%(1/47)］(χ2=0.366, P=0.545). Conclusion  Huperzine A tablet combined with oxiracetam capsule has good clinical efficacy in the treatment of VCI after cerebral infarction, which is helpful to improve the cognitive function of patients, and its effect may be related to the inhibition of inflammatory response and the improvement of vascular endothelial function, and has good safety.