CAJ | 학술논문

目的：观察丁苯酞对急性缺血性卒中患者认知功能的影响。方法首次发病的急性缺血性脑卒中患者104例，均为新乡医学院第一附属医院神经内科2012年10月至2013年6月连续住院患者。随机分为对照组54例和治疗组50例，均予以标准化治疗，治疗组在此基础上加服丁苯酞软胶囊。认知功能评定采用北京版蒙特利尔认知评估（MoCA）量表和简明智力状态检查（MMSE）量表，高敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）浓度测定，分别在治疗前及治疗后1个月进行。运用统计软件进行t检验、χ2检验、秩和检验及Logistic回归分析。结果治疗后1个月，治疗组患者血清Hcy、hs-CRP浓度较对照组明显下降（ t＝5.4273、4.3459，P均＜0.05）。治疗后治疗组及对照组认知功能损害及血管性痴呆分别占88％、87％和64％、70.4％。治疗组总体认知功能显著改善，其中命名、记忆力、注意力和语言能力改善显著（ z值分别为-2.75、-3.09、-2.63、-2.82， P均＜0.05）。血清Hcy浓度是急性缺血性卒中后1个月痴呆的危险因素（ OR值为3.563，95％ CI 0.799～5.637）。结论丁苯酞可显著改善急性缺血性卒中患者认知功能，其机制可能与降低血清Hcy浓度有关。
목적：관찰정분태대급성결혈성졸중환자인지공능적영향。방법수차발병적급성결혈성뇌졸중환자104례，균위신향의학원제일부속의원신경내과2012년10월지2013년6월련속주원환자。수궤분위대조조54례화치료조50례，균여이표준화치료，치료조재차기출상가복정분태연효낭。인지공능평정채용북경판몽특리이인지평고（MoCA）량표화간명지력상태검사（MMSE）량표，고민C반응단백（hs-CRP）、동형반광안산（Hcy）농도측정，분별재치료전급치료후1개월진행。운용통계연건진행t검험、χ2검험、질화검험급Logistic회귀분석。결과치료후1개월，치료조환자혈청Hcy、hs-CRP농도교대조조명현하강（ t＝5.4273、4.3459，P균＜0.05）。치료후치료조급대조조인지공능손해급혈관성치태분별점88％、87％화64％、70.4％。치료조총체인지공능현저개선，기중명명、기억력、주의력화어언능력개선현저（ z치분별위-2.75、-3.09、-2.63、-2.82， P균＜0.05）。혈청Hcy농도시급성결혈성졸중후1개월치태적위험인소（ OR치위3.563，95％ CI 0.799～5.637）。결론정분태가현저개선급성결혈성졸중환자인지공능，기궤제가능여강저혈청Hcy농도유관。
Objective To observe the influence of Dl-3-butylphthalide on cognitive impairment in patients with acute ischemic stroke .Methods One hundred and four cases of acute ischemic stroke were randomly divided into treatment group (50 cases treated with Dl-3-butylphthalide and routine therapy ,totally 20 days)and control group (54 cases treated with routine therapy ).The cognitive state was evaluated by Chinese version of Montreal Cognitive Assessment and Mini-mental State Examination before and 1 month after treatment,and the serum levels of homocysteine ( Hcy) and high-sensitive C-reactive protein ( hs-CRP) were investigated 1 month before and after treatment .Results The serum levels of Hcy and hs-CRP of the treatment group was lower than that of the control group after 1month(t=5.427 3,4.345 9,all P<0.05). After treatment ,there was difference in the rates of vascular cognitive impairment with no de-mentia 88%, 87% and 64%, 70.4%.The global cognitive function , style, memory, attention and language ability significantly improved in the treatment group (z=-2.75,-3.09,-2.63,-2.82,all P<0.05).Multiple stepwise regression analysis showed the concentration of serum Hcy was a risk factor of dementia 1months after ischemic stroke(OR 3.563,95% CI 0.799-5.637).Conclusion Our research indicates that Dl-3-butylphthalide can improve cognitive probably through down regulating of Hcy expression of serum .