曲美他嗪治疗急性缺血性血管性痴呆疗效分析

目的: 探讨曲美他嗪治疗急性缺血性血管性痴呆(VD)的疗效。方法: 将98例急性缺血性VD患者随机分为治疗组和对照组, 对照组予阿司匹林肠溶片、辛伐他汀、血塞通和奥拉西坦治疗, 疗程3周;治疗组在对照组治疗的基础上, 加用曲美他嗪口服, 20 mg, 每天3次。分别于用药前和用药后第1、2、3周应用简易智能量表、临床痴呆评定量表和生活能力量表评分, 并在用药前后检测血清总胆固醇(TCH)、三酰甘油(TG)和同型半胱氨酸(HCY)水平。结果: 治疗组患者治疗后第1、2、3周简易智能量表评分逐渐升高、临床痴呆评定量表和生活能力量表评分逐渐下降, 与治疗前比较, 第2周后所有评分差异均有统计学意义(P<0.01)。治疗3周后, 治疗组总有效率83.7%, 高于对照组的20.4%(P<0.01);同时治疗组TCH、TG和HCY水平均较治疗前明显下降(P<0.01), 而对照组TG和HCY水平亦较治疗前下降(P<0.01);结论: 曲美他嗪既能降低TCH、TG和HCY的水平, 减少缺血性VD的发作, 又能治疗急性缺血性VD, 2周后疗效显著。

The curative effect of trimetazidine in the treatment of acute ischemic vascular dementia

Objective:To investigate the curative effects of trimetazidine in the treatment of acute ischemic vascular dementia. Methods:Ninety-eight patients with acute ischemic vascular dementia were randomly divided into the treatment group and control group. The control group were treated with aspirin enteric-coated tablets,simvastatin,xuesaitong combined with oxiracetam for 3 weeks, the treatment group were additionally treated with 20 mg of trimetazidine by oral,3 times a day,based on the control group. The scores of MMSE,CDR and ADL before treatment and after 1,2 and 3 weeks of treatment and levels of TCH,TG and HCY before and after treatment in two groups were measured. Results:In treatment group, the MMSE score, and CDR and ADL scores increased and decreased gradually after 1,2 and 3 weeks of treatment,respectively. The differences of the all scores between before treatment and after 2 weeks of treatment in treatment group were statistically significant(P<0. 01). After 3 weeks of treatment,the total effective rate in treatment group(83.7%)was higher than that in control group(20.4%)(P<0.01).Compared with before treatment,the levels of TCH,TG and HCY in treatment group and levels of TG and HCY in control group were significantly low after treatment(P<0. 01). Conclusions:Trimetazidine can reduce the levels of TCH, TG and HCY. Trimetazidine can reduce and treat the ischemic vascular dementia,the treatment effect of which is significant after 2 weeks of treatment.