艾司西酞普兰联合奥拉西坦治疗脑卒中后认知功能障碍的临床研究OA

Objective To investigate the clinical efficacy and safety of escitalopram tablets and oxiracetam capsules in treating post-stroke cognitive impairment(PSCI)patients.Methods Patients with PSCI were divided into treatment group and control group using a random number table.The control group received oxiracetam capsules(0.8 g each time,twice daily),and the treatment group additionally received escitalopram tablets(initially 5 mg once daily,increased to 10 mg once daily after 1 week).The efficacy,scale score,cerebral blood flow,serum indicators and safety of the two groups were compared and analyzed.Results Finally,60 cases were included in each group.After treatment,the mini-mental state examination(MMSE)scores in control and treatment groups were(20.85±4.38)and(23.67±4.81)points,respectively;activities of daily living(ADL)scores were(58.92±6.87)and(67.53±7.72)points,respectively;neuropsychiatric inventory(NPI)scores were(59.85±6.93)and(48.88±5.73)points,respectively;anterior cerebral artery blood flow velocity was(48.97±5.77)and(53.81±6.45)cm·s-1,respectively;middle cerebral artery blood flow velocity was(63.97±7.45)and(75.23±8.63)cm·s-1,respectively;posterior cerebral artery blood flow velocity was(35.28±4.24)and(41.25±5.06)cm·s-1,respectively;C-reactive protein(CRP)levels were(4.89±1.03)and(3.13±0.84)mg·L-1,respectively;neuron-specific enolase(NSE)levels were(20.64±3.21)and(16.28±2.45)ng·mL-1,respectively;homocysteine(Hcy)levels were(22.31±3.42)and(16.84±2.82)μmol·L-1,respectively.The above indicators all had statistically significant difference compared between the two groups(all P＜0.05).The total effective rates of the treatment group and the control group were 90.00％(54 cases/60 cases)and 71.67％(43 cases/60 cases),with a statistically significant difference(P＜0.05).The adverse drug reactions of control group were nausea and vomiting,constipation and insomnia,while the adverse drug reactions of treatment group were nausea and vomiting,dizziness,constipation and insomnia.The total incidences of adverse drug reactions were 8.33％(5 cases/60 cases)and 5.00％(3 cases/60 cases),respectively,with no statistically significant difference(P＞0.05).Conclusion The combination of escitalopram tablets and oxiracetam capsules in the clinical treatment of PSCI patients can obviously improve the clinical efficacy,quality of life and mental state of patients,improve cerebral blood flow,reduce serum CRP,Hcy and NSE levels,and have high safety during the treatment process.