尼麦角林联合经颅刺激仪治疗脑卒中后认知障碍患者的疗效及对脑内代谢的影响OACSTPCD

Objective To analyze the clinical efficacy of nicergoline combined with transcranial stimulator in treating patients with post-stroke cognitive dysfunction and the effect on intracerebral metabolism.Methods Clinical data were retrospectively analyzed,and 197 patients with post-stroke cognitive dysfunction admitted to the Affiliated Hospital of the Institute of Neurology,Anhui University of Traditional Chinese Medicine from October 2020 to March 2023 were selected,and were divided into the nicergoline group(n=99)and the combined group(n=98)according to the treatment modality,and nicergoline was given to the nicergoline group,and the combined group was given to the nicergoline+transcranial stimulation device treatment,and the therapeutic efficacy was compared between the two groups.The cognitive function status(mini-mental examination(MMSE)score,Rivermead behavioural memory test(RBMT)score),intracerebral metabolism(NAA/Cr,Cho/Cr)and event related points(ERPs)(P300 wave amplitude,P300 latency)changes were compared,and the levels of serum nerve injury markers(neuron-specific enolase(NSE),S100 protein(S-100 β),ubiquitin carboxyl-terminal hydrolase-1(UCH-L1),and glial progenitor fibrillary acidic protein(GFAP))were compared between the two groups.Results The total effective rates in the nicergoline group and the combination group were 67.68%and 90.82%,respectively,and the total effective rate of treatment for patients in the combination group was significantly higher than that in the nicergoline group(P<0.05).The MMSE score and RBMT score in the combined group after treatment were significantly higher than those of the nicergoline group(P<0.05).The NAA/Cr level of in the combined group after treatment was significantly higher than that of the nicergoline group,and the Cho/Cr level was significantly lower than that of the nicergoline group(P<0.05).The wave amplitude level in the combined group after treatment was significantly higher than that of the nicergoline group,and the latency level was significantly lower than that of the nicergoline group(P<0.05).The levels of NSE,S-100β,UCH-L1 and GFAP in the combined group were significantly lower than those of the nicergoline group after treatment,and the difference was statistically significant(P<0.05).Conclusion Nicergoline combined with transcranial stimulator has better efficacy in treating patients with post-stroke cognitive dysfunction,which can shorten the P300 latency,increase the magnitude,and then improve the cognitive function,and the mechanism may be related to the improvement of cerebral metabolism and the reduction of serum nerve damage markers.