重复经颅磁刺激联合多奈哌齐治疗卒中后轻度认知障碍疗效观察OACSTPCD
Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Donepezil in the Treatment of Mild Post-Stroke Cognitive Impairment
目的 探讨重复经颅磁刺激(rTMs)联合多奈哌齐治疗卒中后轻度认知障碍的临床疗效,以及对患者脑神经代谢物和炎性因子水平的影响.方法 选取医院 2020 年 1 月至 2023 年 10 月收治的卒中后轻度认知障碍患者 145 例,根据治疗方案的不同分为对照组(70 例)和观察组(75 例).两组患者均予多奈哌齐治疗,观察组患者加用rTMS,均治疗 4 周.结果 观察组总有效率为 84.00%,显著高于对照组的 64.29%(P<0.05).治疗后,两组患者的脑神经代谢物[乙酰胆碱(ACh)、血清去甲肾上腺素(NE)、脑组织N-乙酰天门冬氨酸(NAA)与对侧NAA的比值]水平,认知功能[简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、Rivermead行为记忆量表(RBMT)]评分,日常生活能力[改良Barthel指数(MBI)、功能独立性评定量表(FIM)]评分均显著升高(P<0.05),患侧乳酸/对侧肌酸复合物(Lac/Cr)、炎性因子[血清肿瘤坏死因子-α(TNF-α)、白细胞介素 6(IL-6)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)]水平均显著降低(P<0.05),且观察组上述指标改善均更显著(P<0.05).观察组的不良反应发生率为 8.00%,显著低于对照组的 20.00%(P<0.05).结论 rTMS刺激联合多奈哌齐治疗卒中后轻度认知障碍的临床疗效良好,可改善患者的认知功能,提高脑神经代谢物水平和日常生活能力,降低炎性因子水平,促进预后,且安全性较好.
Objective To investigate the clinical efficacy of repetitive transcranial magnetic stimulation combined with donepezil in the treatment of patients with mild post-stroke cognitive impairment(PSCI),and its effect on brain nerve metabolites and inflammatory factors.Methods A total of 145 patients with PSCI admitted to the hospital from January 2020 to October 2023 were selected and divided into the control group(70 cases)and the observation group(75 cases)according to different treatment plans.The patients in the two groups were treated with donepezil,on this basis,the patients in the observation group were treated with repetitive transcranial magnetic stimulation.Both groups were treated for 4 weeks.Results The total effective rate in the observation group was 84.00%,which was significantly higher than 64.29% in the control group(P<0.05).After treatment,the levels of brain nerve metabolites[acetylcholine(ACh),serum norepinephrine(NE),ratio of N-acetylaspartate(NAA)to contralateral NAA in brain tissue],cognitive function[Mini-Mental State Examination Scale(MMSE),Montreal Cognitive Assessment Scale(MoCA),Rivermead Behavioral Memory Test(RBMT)]scores,and ability of daily living[Modified Barthel Index(MBI),Functional Independence Measure(FIM)]in the two groups significantly increased(P<0.05),while the affected side lactate/contralateral creatine complex(Lac/Cr),inflammatory factors[serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),blood homocysteine(Hcy),and C-reactive protein(CRP)]levels in the two groups significantly decreased(P<0.05),and the above indexes in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 8.00%,which was significantly lower than 20.00% in the control group(P<0.05).Conclusion Repeated transcranial magnetic stimulation combined with donepezil has good clinical efficacy and safety in the treatment of mild PSCI,which can improve cognitive function,increase brain nerve metabolite levels and ability of daily living,reduce inflammatory factor levels,and promote prognosis.
彭斌;彭红;许世政;唐捷;卓衍华
四川省南充市中心医院·北京安贞医院南充医院,四川 南充 637000
药学
重复经颅磁刺激多奈哌齐卒中后轻度认知障碍脑神经代谢物炎性因子临床疗效
repetitive transcranial magnetic stimulationdonepezilmild post-stroke cognitive impairmentbrain nerve metabolitesinflammatory factorsclinical efficacy
《中国药业》 2024 (013)
111-114 / 4
四川省基层卫生事业发展研究中心项目[SWFZ22-Y-37].
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