奥拉西坦治疗缺血性脑卒中后认知功能障碍的临床观察

目的：探讨奥拉西坦治疗缺血性脑卒中后认知功能障碍的疗效及安全性。方法：回顾性分析2010年11月-2013年10月濮阳市油田总医院收治的脑卒中后认知功能障碍患者102例，使用随机数字表法分为观察组51例和对照组51例，2组均给予常规治疗，对照组给予口服吡拉西坦片，1600mg／次，3次／d；治疗组给予口服奥拉西坦胶囊，800mg／次，2次／d。2组均治疗4周为1个疗程，连续治疗3个疗程。观察2组蒙特利尔认知评分（MoCA评分）、日常生活能力评分（ADL评分）及P300潜伏期（P300PL）变化。结果：治疗组总有效率为84．31％，明显高于对照组的64．70％，差异具有统计学意义（χ^2=4．18，P〈0．05）。2组MoCA评分和ADL评分均较治疗前明显提高（P〈0．05），治疗组改善程度优于对照组（P〈0．05）。2组P300PL在N2、P3潜伏期、P3波波幅与治疗前比较显著改善（P〈0．05），治疗后组间比较具有统计学意义（P〈0．05）。2组均无严重不良反应发生。结论：奥拉西坦对脑卒中后认知功能障碍患者有效，且改善认知功能障碍程度优于吡拉西坦，安全性好。

Clinical Efficacy of Oxiracetam for Cognitive Dysfunction in Patient with Cerebral Ischemic Stroke

OBJECTIVE：To evaluate the therapeutic efficacy and safety of Oxiracetam for cognitive dysfunction in patients with cerebral ischemic stroke. METHODS： Between Nov. 2011 and Oct. 2013, a total of 102 patients with cognitive dysfunction following development of cerebral ischemic stroke in Puyang Oil Field General Hospital were randomly assigned to two groups of 51 each. The control group received add-on oral Piraeetam Tablets 1 600 mg/time tid and the treatment group received add-on Oxiracetam Capsules（800 mg/time） bid. After three course of treatment （4 weeks in one course of treatment）, Montreal Cognitive Assessment（MoCA）, Activity of Daily Living Scale （ADL） and P300PL（latency period） in the two groups were recorded. RESULTS： The total effective rate in the treatment group was significantly higher than in the control group（84. 31% vs. 64. 70% ）, and the difference between the 2 groups was statistically significant（χ^2 =4. 18, P 〈 0. 05） ; compared with before treatment, the MoCA score and ADL score in both groups were significantly improved after treatment, with treatment group showing better improvement than in the control group （P 〈 0. 05 ）; P300 PL in N2 and P3 latency and amplitude of P3 wave in both groups significantly improved compared with before treatment（P 〈0. 05）, and the differences between the two groups after treatment were statistically significant （P 〈 0. 05 ）. No severe ADR was found for both groups. CONCLUSIONS： Oxiracetam is safe and effective yet it is more effective than Piracetam in the treatment of cognitive dysfunction in patients with cerebral ischemic stroke.