丁苯酞对脑白质疏松患者认知功能和大脑中动脉博动指数的影响

目的 探讨丁苯酞对脑白质疏松(Leukoaraiosis,LA)患者认知功能和大脑中动脉博动指数(Pulsatility index,PI)的影响。方法 收集LA合并认知功能异常的患者100例为LA组,选取非血管性认知功能异常患者100例为NLA组,每组按随机数字表法分为对照组和干预组,干预组常规治疗加丁苯酞软胶囊(0.2g,每日3次),疗程12周。在治疗前后经简易精神状态量表(Mini Mental examination,MMSE)、蒙特利尔认知量表(Montreal cognitive scale assessment,MOCA)和事件相关电位P300测定认知功能及PI。结果 NLA组和LA组治疗12周后,患者的认知功能改善(MMSE和MOCA总分增高、P300电位的波幅增高和潜伏期缩短)、PI值降低(P＜0.05);与常规治疗12周比较,丁苯酞治疗12周后,LA组的认知功能改善、PI值降低(P＜0.05);两组治疗后PI值与认知功能相关(P＜0.05)。结论 丁苯酞软胶囊可改善脑白质疏松患者的认知功能及大脑中动脉的供血,PI值的测定有望成为诊断脑白质疏松伴认知功能障碍的新方法。

Effect of butylphthalide on cognitive function and middle cerebral artery index in patients with leukoaraiosis

Objective To investigate the effect of butylphthalide on the cognitive function and middle cerebral pulsation index(PI)in patients with leukoaraiosis(LA). Methods 100 cases of LA patients with cognitive impairment were collected as LA group,while 100 cases of patients with non-vascular cognitive dysfunction were collected as NLA group.Each group was randomly divided into intervention group and control group.The intervention group received routine treatment plus Butylphthalide Soft Capsules(0.2g,3 times daily for 12 weeks).Before and after treatment,cognitive function and PI were measured by Mini-Mental State Scale(Mini-Mental examination,MMSE),Montreal cognitive assessment(Montreal cognitive scale assessment,MOCA)and event-related potential P300. Results After 12 weeks of treatment in group NLA and group LA,the cognitive function improved(the total score of MMSE and MOCA increased,the amplitude of P300 potential increased and the latency shortened)and the PI value decreased(P<0.05).Compared with the routine treatment for 12 weeks,after 12 weeks of butylphthalide treatment,the cognitive function of the LA group was improved and the PI value was reduced(P<0.05).The PI values were associated with cognitive function after two groups of treatment(P<0.05). Conclusion Butylphthalide Soft Capsules can improve cognitive function and blood supply of middle cerebral artery in patients with leukoaraiosis.PI value is expected to become a new diagnostic method for leukoaraiosis with cognitive impairment.