尼麦角林对脑梗死患者认知功能的影响

背景脑梗死后认知功能障碍发生率高达20%～30%,临床亟待开发防治有效的药物.目的了解尼麦角林防治脑梗死后认知功能障碍发生的效果以及探讨其作用机制.设计以患者为研究对象的随机对照研究.单位一所医科大学医院的神经内科.对象选择1999-10/2001-04重庆医科大学第二附属医院神经内科脑梗死患者60例,随机分成两组,尼麦角林治疗组(30例)和对照组(30例).方法入院1周内和3个月后分别进行MMSE评分和经颅多普勒检查,用SPSS8.0统计软件处理数据.主要观察指标尼麦角林对脑梗死患者MMSE评分及脑血流速度的影响,并与对照组比较.结果3个月后对照组MMSE评分在记忆力、计算能力和回忆能力方面显著下降,分别为(1.2±1.3),(2.2±2.1),(1.0±1.7)分,而治疗组的评分下降则不明显,分别为(3.9±1.4),(4.4±1.9),(4.0±1.6)分;3个月后对照组大脑血流速度明显下降,而治疗组大脑血流速度明显提高,右侧大脑中动脉速度分别为(58.31±10.15),(65.79±9.74)cm/s.结论尼麦角林在防治血管性认知功能障碍方面有显著的效果.改善脑的血供可能是尼麦角林改善脑梗死认知功能障碍的原因之一.

Effect of nicergolineon cognition function of patients with cerebral infarction

BACKGROUND: The incidence of cognition disturbance after cerebral infarction is about 20% -30% and effective drugs for its prevention and treatment are anticipated.OBJECTIVE: To investigate the effect of nicergoline on cognition disturbance after cerebral infarction and explore its mechanism.DESIGN: Randomized controlled trial based on patients.SETTING: Neurological department in a medical university.PARTICIPANTS: A total of 60 patients admitted to the Neurological Department of the Second Hospital Affiliated to Chongqing Medical University for cerebral infarction during October 1999 and April 2001 were recruited in this study, and randomly divided into two groups, nicergoline treatment group and control group with 30 in each.METHODS: Mini-mental state examination(MMSE) score was evaluated and cerebral blood flow was determined with transcranial Doppler' s ultrasonography within one week after admission and three months after admission, respectively, and data were analyzed with SPSS software.MAIN OUTCOME MEASURES: MMSE score and velocity of blood flow in treatment and control groups.RESULTS: MMSE score in memory, calculation and recollection decreased significantly[ (1.2 ± 1.3), (2. 2 ± 2. 1) and(1.0 ± 1.7), respectively] in control group but did not change much[ (3.9 ± 1.4), (4. 4 ± 1.9) and(4.0 ± 1.6) ]in treatment group. The velocity of blood flow in control group decreased apparently, while it increased in treatment group[(58.31 ±10. 15) and(65.79 ±9.74) cm/s in the right middle cerebral artery].CONCLUSION: Nicergoline can prevent and treat vascular cognition disturbance, and improvement of blood supply may be one of the mechanisms.