[1]王亚妮,李维婷,袁成代,等.丁苯酞联合胞磷胆碱钠片治疗非痴呆性血管性认知障碍临床疗效及与同型半胱氨酸、甲状腺激素水平相关性研究[J].陕西医学杂志,2022,51(10):1285-1289.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.027]
　WANG Yani,LI Weiting,YUAN Chengdai,et al.Effect of butylphthalide combined with citicoline sodium tablets in treatment of non-dementia vascular cognitive impairment and its correlation with the levels of Hcy and thyroid hormones in patients[J].,2022,51(10):1285-1289.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.027]
点击复制

丁苯酞联合胞磷胆碱钠片治疗非痴呆性血管性认知障碍临床疗效及与同型半胱氨酸、甲状腺激素水平相关性研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年10期
页码:
1285-1289
栏目:
药物与临床
出版日期:
2022-10-05

文章信息/Info

Title:
Effect of butylphthalide combined with citicoline sodium tablets in treatment of non-dementia vascular cognitive impairment and its correlation with the levels of Hcy and thyroid hormones in patients
作者:
王亚妮1; 李维婷1; 袁成代1; 李红兵2
(1.宝鸡市中医医院临床药学室,陕西 宝鸡721001; 2.西安国际医学中心医院药学部,陕西 西安710100)
Author(s):
WANG Yani; LI Weiting; YUAN Chengdai; LI Hongbing
(Department of Pharmacy,Baoji Hospital of Traditional Chinese Medicine,Baoji 721001,China)
关键词:
丁苯酞;  胞磷胆碱钠片;  非痴呆性血管性认知障碍;  同型半胱氨酸;  甲状腺激素
Keywords:
Butylphthalide;  Citicoline sodium tablets;  Non-dementia vascular cognitive impairment;  Homocysteine;  Thyroid hormone
分类号:
R 741.05
DOI:
DOI:10.3969/j.issn.1000-7377.2022.10.027
文献标志码:
A
摘要:
目的:探究丁苯酞联合胞磷胆碱钠片治疗非痴呆性血管性认知障碍(VCIND)的效果及与患者同型半胱氨酸(Hcy)、甲状腺激素水平的相关性。方法:纳入VCIND患者200例,按照随机数字表法分为A组、B组、C组和D组,各50例。A组行常规治疗,B组使用胞磷胆碱钠片,C组使用丁苯酞,D组使用胞磷胆碱钠片联合丁苯酞。比较四组的治疗有效率、治疗前后的认知功能评分、Hcy、甲状腺激素水平。将治疗无效的患者纳入无效组,治疗有效和显效的患者纳入有效组,比较两组的Hcy、甲状腺激素水平和变化率,使用ROC曲线分析Hcy、甲状腺激素变化率与VCIND治疗效果的相关性。结果: D组的治疗有效率明显高于A组、B组以及C组(均P<0.05)。治疗后,D组的MoCA评分、Hcy、FT3水平均优于A组、B组、C组,比较差异具有统计学意义(均P<0.05)。治疗后,有效组Hcy、游离三碘甲状腺原氨酸(FT3)水平,以及Hcy、FT3变化率均优于无效组,比较差异具有统计学意义(均P<0.05)。对VCIND患者疗效评估中,Hcy应用下,AUC为0.868(95%CI:0.802～0.934),FT3应用中,AUC为0.710(95%CI:0.632～0.787),灵敏度70.70%、特异度81.70%。结论:丁苯酞联合胞磷胆碱钠片治疗VCIND的效果确切,有助于患者认知功能的改善,其中Hcy、FT3水平与患者治疗效果相关,Hcy、FT3变化率可作为评估VCIND患者疗效的有效指标。
Abstract:
Objective:To study the effect of butylphthalide combined with citicoline sodium tablets in the treatment of non-demented vascular cognitive impairment(VCIND)and its correlation with the levels of homocysteine(Hcy)and thyroid hormones in patients.Methods:A total of 200 VCIND patients were included and divided into group A,group B,group C and group D according to the random number table method,50 cases in each.Group A received routine treatment,group B received citicoline sodium tablets,group C received butylphthalide,and group D received citicoline sodium tablets combined with butylphthalide.The treatment efficiency,cognitive function scores,Hcy and thyroid hormone levels before and after treatment were compared among the four groups.The ineffective patients were included in the ineffective group,and the effective and markedly effective patients were included in the effective group,and the levels and change rates of Hcy and thyroid hormones were compared between the two groups.ROC curve was used to analyze the correlation between the change rate of Hcy,thyroid hormones and the treatment effect of VCIND.Results:The effective rate of group D was significantly higher than that of group A,group B and group C(all P<0.05).After treatment,the MoCA score,Hcy and FT3 levels of group D were better than those of group A,group B and group C(all P<0.05).After treatment,the levels of Hcy and FT3,as well as the change rates of Hcy and FT3 in the effective group were better than those in the ineffective group(all P<0.05).In the evaluation of the efficacy of VCIND patients,the AUC of Hcy was 0.868(95%CI:0.802 to 0.934),and the AUC of FT3 was 0.710(95%CI:0.632 to 0.787),with a sensitivity of 70.70% and a specificity of 81.70%.Conclusion: Butylphthalide combined with citicoline sodium tablets is effective in the treatment of VCIND,which helps to improve the cognitive function of patients.The levels of Hcy and FT3 are related to the treatment effect of patients,and the change rate of Hcy and FT3 can be used as an effective method to evaluate the curative effect of VCIND patients.

参考文献/References:

[1] 李 晗,王 蕾.血管性认知障碍发病机制的研究进展[J].中国病理生理杂志,2021,37(2):363-368.
[2] 李 岩,于洪波,王兴河.丁苯酞注射液治疗脑梗死后认知功能障碍疗效的Meta分析[J].神经疾病与精神卫生,2018,18(2):119-124.
[3] 李会琪,刘 红,张 恒,等.卒中后非痴呆型认知障碍与Hcy、白质疏松及P300相关性研究[J].陕西医学杂志,2018,47(2):153-155,189.
[4] 孔伟丽,王 琴,吕 康,等.急性脑梗死后血清甲状腺激素水平与认知功能的相关性分析[J].解放军医药杂志,2021,33(10):7977-7983.
[5] 中国医师协会神经内科分会认知障碍专业委员会,《中国血管性认知障碍诊治指南》编写组.2019年中国血管性认知障碍诊治指南[J].中华医学杂志,2019,99(35):2737-2744.
[6] 王慕秋,任明山.蒙特利尔认知评价量表在非痴呆型血管性认知障碍早期筛查中的应用[J].国际脑血管病杂志,2011,9(12):921-924.
[7] 卜范艳,崔晓雪,王伊林,等.银杏叶软胶囊口服辅助治疗非痴呆性血管认知障碍的疗效及其作用机制[J].山东医药,2016,56(43):66-68.
[8] 贾建平,王荫华,张振馨,等.中国痴呆与认知障碍诊治指南(三):神经心理评估的量表选择[J].中华医学杂志,2011,91(11):735-741.
[9] 洪 霞,张振馨,武力勇,等.听觉词语学习测验对阿尔茨海默病的诊断价值[J].中国医学科学院学报,2012,34(3):262-266.
[10] 孙 宇,韩 璎,戴建平.血管性认知障碍诊断标准的演变与解读[J].中国卒中杂志,2017,27(1):13-17.
[11] 康宪政,李玉方,孟 森.胞磷胆碱联合丁苯酞软胶囊治疗老年脑梗死后血管性痴呆的效果及对认知功能的影响[J].中国实用医刊,2021,48(24):103-106.
[12] 尤晓涵,杨 淼,明霞光,等.盐酸川芎嗪注射液联合丁苯酞软胶囊治疗急性脑梗死疗效及对患者血液流变学影响[J].陕西中医,2020,41(6):743-745,757.
[13] 张春丽,张 颖,李 璐,等.脑小血管病患者血清CTRP1和同型半胱氨酸水平对血管性轻度认知障碍预测价值的研究[J].现代检验医学杂志,2022,37(1):182-185,194.
[14] 郭 盼,李菁媛,刘 颖,等.阿尔茨海默病患者血脂及甲状腺激素水平变化的研究[J].中国医师杂志,2019,21(12):1848-1851.
[15] 张威威,尹博文,陈 钊,等.胞磷胆碱联合丁苯酞软胶囊治疗脑梗死后血管性痴呆的效果及对心理状态的影响[J].解放军医药杂志,2021,33(1):39-43.
[16] 邹晶晶,齐艳春,尹丽霞.丁苯酞对脑出血后轻度血管性认知功能障碍患者的疗效研究[J].河北医学,2021,27(12):2052-2055.
[17] 赵永红,张鸿儒.同型半胱氨酸与老年患者血管性认知功能障碍的临床研究[J].中国药物与临床,2020,20(19):3232-3234.
[18] 廖建红,孙胜奎,刘俊峰,等.脑出血病人Hcy、NSE水平变化及其与认知功能的关系[J].中西医结合心脑血管病杂志,2021,19(16):2855-2858.
[19] 毛 蕾,李 澎,陈晓晗,等.血清Aβ1-42、tau蛋白及甲状腺激素水平对缺血性卒中后认知障碍发生的预测价值[J].中国神经精神疾病杂志,2019,45(7):385-389.
[20] 高立伟,张 强,李 萌,等.丁苯酞对血管性痴呆小鼠认知功能的影响及Nrf2/SIRT3信号通路的调节作用[J].中华行为医学与脑科学杂志,2020,29(3):200-206.

相似文献/References:

[1]雷 敏,吴丽荣,刘 英.丁苯酞对脑卒中后抑郁患者血清同型半胱氨酸、神经细胞因子、单胺类递质和炎症因子的影响研究*[J].陕西医学杂志,2019,(7):853.
　LEI Min,WU Lirong,LIU Ying..Effects of butylphthalide on serum Hcy，neurocytokines，monoamine transmitters and inflammatory factors in patients with post-stroke depression[J].,2019,(10):853.

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2021-GJL0021)
更新日期/Last Update: 2022-10-07