丁苯酞联合美金刚早期治疗急性缺血性卒中后失语的有效性和安全性研究

doi:10.3969/j.issn.1673-5765.2021.02.012

摘要/Abstract

摘要：

目的探讨丁苯酞联合美金刚早期治疗急性缺血性卒中后失语（post-stroke aphasia，PSA）的有效性和安全性。方法前瞻性连续纳入2019年1月-2020年3月于青岛大学附属烟台毓璜顶医院神经内科收治的60 例首次发病的PSA患者，采用随机数字表法分为观察组和对照组，每组30例。对照组给予丁苯酞序贯治疗，观察组在对照组基础上联合美金刚10 mg/d口服，治疗90 d。比较两组治疗14 d和90 d时的西方失语成套测验（western aphasia battery，WAB）-失语商（aphasia quotient，AQ）评分（包括自发言语、听理解、复述、命名4个亚项和AQ评分），90 d时NIHSS和mRS评分，以及肝肾功能情况。结果治疗前，两组NIHSS、WAB-AQ各项评分差异均无统计学意义。治疗14 d时，两组WAB-AQ各项评分差异无统计学意义。治疗90 d时，观察组WAB中自发言语（P =0.006）、听理解（P =0.048）、复述（P＜0.001）、命名（P =0.001）亚项及AQ评分（P =0.001）均高于对照组；NIHSS评分[1.0（0.0～3.0）分 vs 3.0（1.0～10.0）分，P =0.029]和mRS评分[1.0（0.0～1.0）分 vs 1.5（1.0～3.0）分，P =0.004]均低于对照组。两组治疗90 d时肝肾功能检查结果均正常。结论丁苯酞联合美金刚治疗可改善PSA患者的神经功能、生活自理能力、言语功能，且安全性较高。

文章导读： 对于左侧大脑中动脉及其支配区域的左侧外侧裂周围PSA患者，早期丁苯酞联合美金刚治疗的临床效果较好，且安全性良好。

关键词: 卒中后失语; 美金刚; 丁苯酞; 西方失语成套测验-失语商测评

Abstract:

Objective To explore the effectiveness and safety of butylphthalide combined with memantine in the early treatment of aphasia after acute ischemic stroke. Methods From January 2019 to March 2020, 60 patients with first-onset post-stroke aphasia (PSA) who admitted to Department of Neurology, Yantai Yuhuangding Hospital, Qingdao University, were prospectively enrolled in this study. All the subjects were randomly divided into observation and control groups, with 30 cases in each group. The observation group was given sequential butylphthalide treatment combined with memantine 10 mg/d orally, and the control group was given sequential butylphthalide treatment for 90 days. The Western aphasia battery (WAB) -aphasia quotient (AQ) scores (including self-speaking, listening comprehension, retelling and naming 4 subitems and AQ scores) at 14 and 90 days of treatment, NIHSS and mRS scores at 90 days were compared between the two groups. The liver and kidney functions of the two groups at 90 days were also compared. Results Before treatment, there was no statistical difference in baseline NIHSS and WAB scores between the two groups. At 14 days of treatment, there was no statistical difference in the subitem scores of WAB-AQ between the two groups; at 90 days of treatment, the scores of WAB selfspeaking (P =0.006), listening comprehension (P =0.048), retelling (P <0.001), naming (P =0.001) and AQ (P =0.001) of observation group were higher than that of control group. NIHSS [1.0 (0.0-3.0) vs 3.0 (1.0-10.0), P =0.029] and mRS score [1.0 (0.0-1.0) vs 1.5 (1.0-3.0), P =0.004] at 90 days in observation group were lower than that in control group. Liver and kidney function tests in both groups were normal at 90 days. Conclusions Butylphthalide combined with memantine can improve neurological function, selfcare ability and language function of PSA, which had good safety.

Key words: Post-stroke aphasia; Memantine; Butylphthalide; Western aphasia battery-aphasia quotient

于晓辉，张俊良，黄双凤，赵裕君，魏红春，陶曼丽，梁志刚. 丁苯酞联合美金刚早期治疗急性缺血性卒中后失语的有效性和安全性研究[J]. 中国卒中杂志, 2021, 16(02): 175-180.

YU Xiao-Hui, ZHANG Jun-Liang, HUANG Shuang-Feng, ZHAO Yu-Jun, WEI Hong-Chun,TAO Man-Li, LIANG Zhi-Gang. Clinical Efficacy and Safety of Butylphthalide Combined with Memantine in Treatment of Aphasia after Acute Ischemic Stroke[J]. Chinese Journal of Stroke, 2021, 16(02): 175-180.

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