目的:观察奥拉西坦在治疗不同程度血管性认知障碍(vascular cognitive impairment,VCI)患者中的临床疗效?方法:选取VCI患者60例,包括非痴呆的血管性认知障碍(vascular cognitive impairment no dementia,VCIND)患者和血管性痴呆(vascular dementia,VD)患者各30例?所有患者在常规药物治疗的基础上口服奥拉西坦治疗?观察两组患者治疗前后事件相关电位-P300(event-related potentials P300,ERP-P300)及蒙特利尔认知功能评估量表(montreal cognitive assessment,MoCA)评分的变化,并进行比较?结果:患者治疗后MoCA均较前增高(VCIND:t = 11.886,P < 0.01;VD:t = 2.242,P < 0.05)?治疗后VCIND患者P300潜伏期明显缩短(t = 5.799,P < 0.01),波幅明显增高(t = 17.603,P < 0.01),差异有统计学意义,而VD患者P300无明显改变(潜伏期:t = 1.414,P > 0.05;波幅:t = 1.069,P > 0.05)?两组患者MoCA?ERP-P300潜伏期及波幅治疗前后的差值比较,差异均有统计学意义(t值分别为2.135?4.402?7.682,P < 0.05)?结论:奥拉西坦可改善VCI患者的认知功能,对VCIND患者更为有效?
Objective:To investigate the effects of oxiracetam treatment for vascular cognitive impairment(VCI) in varying degrees. Methods:Sixty patients with VCI were selected. Among them,30 patients were with vascular cognitive impairment no dementia(VCIND)and 30 patients with vascular dementia(VD). All patients received conventional base treatment and the oxiracetam treatment. The event-related potentials P300(ERP-P300) and Montreal cognitive assessment(MoCA) of all patients were observed and compared before and after the treatment. Results:After the treatment,the scores of MoCA of all patients showed improvement(VCIND:t = 11.886,P < 0.01;VD:t = 2.242,P < 0.05). After the treatment,ERP-P300 of the VCIND group was improved significantly,the latency period of ERP-P300(P300-PL) was significantly shortened(t = 5.799,P < 0.01) while the amplitude(P300-Amp) was significantly increased(t = 17.603,P < 0.01);but the ERP-P300 of the VD group had no obvious improvement(PL:t = 1.414,P > 0.05;Amp:t = 1.069,P > 0.05). There were significant differences in the scores of MoCA,the latency period and amplitude of ERP-P300 between VCIND group and VaD group(t = 2.135,4.402,7.682,P < 0.05). Conclusion:Oxiracetam are beneficial in the treatment of VCI,especially effective to the patients with VCIND.