丁苯酞对轻度血管性认知障碍患者执行功能的影响
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摘要
目的评估口服丁苯酞对血管性轻度认知障碍患者执行能力的影响。方法选择轻度血管性认知功能障碍患者48例,分为观察组24例,对照组24例。观察组服用丁苯酞200 mg,每日3次,对照组服用维生素E100 mg,每日3次,共90 d。比较两组治疗前及治疗后连线A和连线B测试、数字广度顺背倒背、言语流畅性测验(verbalfluencytest,VFT)、画钟测验量表评分,评价丁苯酞对患者执行功能的影响。结果治疗前,两组认知和执行功能差异无统计学意义。治疗后,观察组连线A[(53.65±0.88)vs(56.22±0.87)]和连线B[(174.95±1.99)vs(177.41±1.44)]测试评分低于对照组,差异有统计学意义;数字广度顺背倒背测试[(5.05±1.22)vs(4.59±0.33)]和VFT[(13.29±0.88)vs(12.43±1.02)]评分高于对照组,差异有统计学意义;两组画钟测试差异无统计学意义。结论丁苯酞可以改善轻度血管性认知障碍患者执行功能。
Objective To evaluate the effect of butylphthalide on executive function in patients with mild vascular cognitive impairment(MVCI). Methods A total of 48 MVCI patients were included in this study, all of whom were divided into observation group(n =24) and control group(n =24). On the base of conventional therapy, Butylphthalide(200 mg, tid) was added to the observation group, and Vitamin E(100 mg, tid) was added to control group, with a treatment course of 90 days in each group. Executive function of patients were evaluated by the following tests: trail making test A and B(TMT-A and B), digit span test(including forward and backward), verbal fluency test(VFT) and clock drawing task. Executive function changes of two groups before and after treatment between the two groups were compared to evaluate the effect of butylphthalide on executive function in MVCI patients.Results The baseline cognition and executive function of two groups had no statistical difference. After treatment, the TMT-A [(53.65±0.88) vs(56.22±0.87)] and TMT-B [(174.95±1.99) vs(177.41±1.44)] scores in observation group were significantly lower than that in control group, the digit span forward and backward score [(5.05±1.22) vs(4.59±0.33)] and the VFT score [(13.29±0.88) vs(12.43±1.02)] in observation group were significantly higher than that in control group. There was no statistical difference in CDT between the two groups.Conclusions Butylphthalide can improve the executive function of patients with MVCI.
Objective To evaluate the effect of butylphthalide on executive function in patients with mild vascular cognitive impairment(MVCI). Methods A total of 48 MVCI patients were included in this study, all of whom were divided into observation group(n =24) and control group(n =24). On the base of conventional therapy, Butylphthalide(200 mg, tid) was added to the observation group, and Vitamin E(100 mg, tid) was added to control group, with a treatment course of 90 days in each group. Executive function of patients were evaluated by the following tests: trail making test A and B(TMT-A and B), digit span test(including forward and backward), verbal fluency test(VFT) and clock drawing task. Executive function changes of two groups before and after treatment between the two groups were compared to evaluate the effect of butylphthalide on executive function in MVCI patients.Results The baseline cognition and executive function of two groups had no statistical difference. After treatment, the TMT-A [(53.65±0.88) vs(56.22±0.87)] and TMT-B [(174.95±1.99) vs(177.41±1.44)] scores in observation group were significantly lower than that in control group, the digit span forward and backward score [(5.05±1.22) vs(4.59±0.33)] and the VFT score [(13.29±0.88) vs(12.43±1.02)] in observation group were significantly higher than that in control group. There was no statistical difference in CDT between the two groups.Conclusions Butylphthalide can improve the executive function of patients with MVCI.
引文
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[11]徐一峰,刘登堂,江开达,等.健康人倒背数字作业的脑功能磁共振成像研究[J].中国神经精神疾病杂志,2005,31(2):133-135.
[12]王会,于海华.画钟试验在轻度认知障碍与轻度阿尔茨海默病中的鉴别作用[J].中国康复理论与实践,2014,(9):859-861.
[13]GUO Q H,ZHOU B,ZHAO Q H,et al.Memory and Executive Screening(MES):a brief cognitive test for detecting mild cognitive impairment[J/OL].BMC Neurol,2012,12:119.https://doi.org/10.1186/1471-2377-12-119.
[14]PENG Y,ZENG X K,FENG Y P,et al.Antiplatelet and antithromboti activity of L-3-n-butylphthalide in rats[J].J Cardiovasc Pharmacol,2004,43(6):876-881.
[15]LIU C L,LIAO S J,ZENG J S,et al.Dl-3-nbutylphthalide prevents stroke via improvement of cerebral microvessels in RHRSP[J].J Neurol Sci,2007,260(1-2):106-113.
[16]PENG Y,SUN J,HON S,et al.L-3-n-butylphthalide improves cognitive impairment and reduces amyloidbeta in a transgenic model of Alzheimer’s disease[J].J Neurosci,2010,30(24):8180-8189.
[2]韩璎.血管性认知障碍[J].中国卒中杂志,2018,13(07):696-698.
[3]陆国庆,吴雪钗,胡婷婷.恩必普[J].中国新药杂志,2006,15(7):572-573.
[4]JIA J,WEI C,LIANG J G,et al.The effects of DL-3-n-butylphthalide in patients with vascular cognitive impairment without dementia caused by subcortical ischemic small vessel disease:a multicentre,randomized,double-blind,placebocontrolled trial[J].Alzheimer’s Dement,2016,12(2)89-99.
[5]JIA J P,ZHOU A H,WEI C B,et al.The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese[J].Alzheimer’s Dement,2014,10(4):439-447.
[6]ROCKWOOD K,WENTZEL C,HACHINSKI V,et al.Prevalence and outcomes of vascular cognitive impairment investigators of the Canadian Study of Health and Aging[J].Neurology,2000,54(2):447-451.
[7]郭起浩,金丽琳,傅建辉,等.不同类型的血管性认知损害的执行功能障碍[J].中华神经科杂志,2009,42(5):314-318.
[8]KALARIA R N.Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer’s disease[J].Acta Neuropathol,2016,131(5):659-685.
[9]王宇,焦劲松,刘尊敬,等.轻度阿尔茨海默病患者连线试验与SPECT脑灌注成像的相关性研究[J].医学临床研究,2015,32(6):1041-1044.
[10]王黎萍,孙新芳,吴承龙,等.帕金森病患者言语流畅性损害[J].河北医科大学学报,2011,32(3):259-261.
[11]徐一峰,刘登堂,江开达,等.健康人倒背数字作业的脑功能磁共振成像研究[J].中国神经精神疾病杂志,2005,31(2):133-135.
[12]王会,于海华.画钟试验在轻度认知障碍与轻度阿尔茨海默病中的鉴别作用[J].中国康复理论与实践,2014,(9):859-861.
[13]GUO Q H,ZHOU B,ZHAO Q H,et al.Memory and Executive Screening(MES):a brief cognitive test for detecting mild cognitive impairment[J/OL].BMC Neurol,2012,12:119.https://doi.org/10.1186/1471-2377-12-119.
[14]PENG Y,ZENG X K,FENG Y P,et al.Antiplatelet and antithromboti activity of L-3-n-butylphthalide in rats[J].J Cardiovasc Pharmacol,2004,43(6):876-881.
[15]LIU C L,LIAO S J,ZENG J S,et al.Dl-3-nbutylphthalide prevents stroke via improvement of cerebral microvessels in RHRSP[J].J Neurol Sci,2007,260(1-2):106-113.
[16]PENG Y,SUN J,HON S,et al.L-3-n-butylphthalide improves cognitive impairment and reduces amyloidbeta in a transgenic model of Alzheimer’s disease[J].J Neurosci,2010,30(24):8180-8189.