尤瑞克林治疗血管性认知障碍的临床疗效观察

目的观察血管性认知障碍患者应用尤瑞克林的疗效及安全性,并初步探讨其可能的作用机制。方法选取2016年1-8月我院神经内科收治的血管性认知障碍患者48例,随机分为2组。观察组24例,给予静脉滴注注射用尤瑞克林治疗;对照组24例,给予静脉滴注奥拉西坦注射液治疗。治疗周期为21 d。对比治疗前后两组患者颈内动脉系统(双侧大脑前动脉ACA、双侧大脑中动脉MCA)和椎-基底动脉系统(双侧大脑后动脉PCA、双侧椎动脉VA、基底动脉BA)的平均血流速度、Addenbrooke改良认知评估量表(ACE-R)评分、简易智力状态检查量表(MMSE)评分、血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE),观察临床疗效。结果两组患者入院时一般基线资料比较差异无统计学意义(P>0.05);治疗后,两组患者认知功能障碍相关症状较治疗前均有好转;颈内动脉系统、椎-基底动脉系统平均血流速度较治疗前均改善,且观察组改善程度明显优于对照组,差异均有统计学意义(P<0.05);两组ACE-R、MMSE量表评分均有升高,且观察组较对照组升高明显,差异均有统计学意义(P<0.05);治疗后两组患者VEGF均升高、NSE均降低,观察组较对照组变化明显,差异均有统计学意义(P<0.05)。结论尤瑞克林可明显改善血管性认知障碍患者脑部血流状态及认知功能,在临床治疗中具有较高的应用价值。其机制可能与提高患者VEGF水平,促进脑微循环生成,并且降低NSE水平,抑制缺血性脑损伤有关。

Efficacy of urinary kallidinogenase in the treatment of vascular cognitive impairment

Objective To observe the efficacy and safety of urinary kallidinogenase in patients with vascular cognitive impairment and to explore the possible mechanism.Methods A total of 48 cases of vascular cognitive impairment admired to Neurology Department of our hospital from January to August 2016 were randomly divided into 2 groups.Observatien group (n =24) was given intravenous infusion of urinary kallidinogenase treatment,and control group (n =24) was given intravenous infusion of oxiracetam treatment.The treatment cycle was 21 days.Before and after treatment,the internal carotid arteries (ACA,MCA) and vertebrobasilar systembilateral posterior cerebral artery (PCA),VA and basilar artery (BA)],the Addenbrooke Modified Cognitive Assessment Scale (ACE-R),the Mini Mental State Examination (MMSE) score,vascular endothelial growth factor (VEGF) and neuron specificity (NSE)were compared,and the therapeutic effect was evaluated.Results There was no significant difference between the two groups in the data recorded on admission (P ＞ 0.05).After treatment,the clinical symptoms related to cognitive dysfunction in both groups were improved;the average blood flow velocity of the internal carotid artery system and vertebrobasilar system in the two groups was increased,and observation group was better than control group (P ＜ 0.05);the scores of ACE-R and MMSE in both groups were higher,and the scores in observation group were higher than those of control group(P ＜0.05).After treatment,the level of VEGF in both group was increased,and NSE was decreased,and there were significant differences between the 2 groups (P ＜ 0.05).Conclusion Urinary kallidinogenase can obviously improve the cerebral blood flow and cognitive function in patients with vascular cognitive impairment,and has high application value in clinical treatment,by the mechanism of increasing the levels of VEGF,promoting cerebral mlcrocirculation,decreasing the level of NSE,and inhibiting the injury of ischemic brain.