前列地尔联合丁苯酞对LI合并轻度VCI的疗效及其对患者脑血流灌注、氧化应激和认知功能的影响

目的探讨前列地尔注射液联合丁苯酞治疗腔隙性脑梗死(LI)合并轻度血管性认知功能障碍(VCI)的效果及其对患者脑血流灌注、氧化应激和认知功能的影响。方法将382例LI合并轻度VCI患者随机分为对照组和观察组,每组191例,对照组给予丁苯酞注射治疗,观察组基于以上治疗给予前列地尔注射治疗,观察治疗前及治疗1个月后的脑血流灌注情况、氧化应激水平、神经功能损伤标志物水平、认知功能和日常生活活动能力变化。结果治疗1个月后,两组大脑前动脉(ACA)和大脑中动脉(MCA)的平均血流速度提高(P<0.05),两组血清一氧化氮(NO)、内皮素(ET)、丙二醛(MDA)水平降低(P<0.05),超氧化物歧化酶(SOD)水平升高(P<0.05),两组血浆同型半胱氨酸(Hcy)、胱抑素C(CysC)、神经元特异性烯醇化酶(NSE)及脑活性肽100-β(S-100β)水平降低(P<0.05),两组简易精神状态检查测量表(MMSE)评分、蒙特利尔量表(MoCA)评分及日常生活能力量表(ADL)评分升高(P<0.05),上述指标两组比较差异均有统计学意义(P<0.05)。结论前列地尔注射液联合丁苯酞治疗LI合并轻度VCI患者疗效确切,能明显改善脑血流灌注,减轻氧化应激损伤并修复脑组织神经缺损,利于患者认知功能和日常生活活动能力的提高。

Effect of alprostadil combined with butylphthalide on LI complicated with mild VCI and its influence on cerebral blood perfusion,oxidative stress and cognitive function

Objective To investigate the efficacy of alprostadil injection combined with butylphthalide in the treatment of lacunar infarction(LI)complicated with mild vascular cognitive impairment(VCI)and its influence on cerebral blood perfusion,oxidative stress and cognitive function.Methods Totally 382 patients with LI and mild VCI were randomly divided into control group and observation group,191 cases in each group.Both groups were given butylphthalide injection,and observation group was also given prostaglandin injection.Cerebral blood perfusion,oxidative stress level,neurological impairment markers levels,cognitive function and activities of daily living were observed before treatment and after 1 month of treatment.Results After 1 month of treatment,the mean blood flow velocities of anterior cerebral artery(ACA)and middle cerebral artery(MCA)were increased in the two groups(P<0.05);the levels of serum nitric oxide(NO)and endothelin(ET)and malondialdehyde(MDA)were decreased(P<0.05),while the level of superoxide dismutase(SOD)was increased(P<0.05);the levels of plasma homocysteine(Hcy),Cystatin C(CysC),neuron-specific enolase(NSE)and brain active peptide 100-β(S-100β)were decreased(P<0.05),while the scores of mini-mental state examination(MMSE),Montreal scale(MoCA)and ability of daily living scale(ADL)were increased(P<0.05).There were significant differences in the above indexes between the two groups(P<0.05).Conclusion Alprostadil injection combined with butylphthalide has good efficacy in the treatment of patients with LI and mild VCI,and it can improve the cerebral blood perfusion,reduce the oxidative stress injury and repair the nerve defects in brain tissue,which is beneficial to the improvement of cognitive function and ability of daily living.