奥拉西坦对中度颅脑损伤后认知障碍的疗效分析

发布时间：2018-05-06 04:33

本文选题：血清IGF-1 + 奥拉西坦　；参考：《新乡医学院》2017年硕士论文

【摘要】：背景如今,我国创伤性颅脑损伤(traumatic brain injury,TBI)的发病率居高不下,许多颅脑损伤患者意识恢复后遗留了不同程度地认知功能障碍,研究显示重度颅脑损伤患者重返社会可能性小,而轻度颅脑损伤患者伴随认知功能障碍的几率较低,故本研究主要针对中度颅脑损伤患者。而近年来益智类药物逐渐被用到该疾病中,其代表药物奥拉西坦是一种新合成的γ-氨基丁酸(γ-aminobutyric acid,GABA)的衍生物,它主要作用在大脑的皮层、海马等部位,不但能促进学习记忆能力,还可以保护、激活及促进神经细胞功能恢复的一种中枢性神经系统药物。目的探讨奥拉西坦作为一种益智药,对中度颅脑损伤患者认知障碍的疗效,为中度创伤性颅脑损伤患者伤后认知功能障碍的临床治疗提供一些理论根据与新思路,为认知障碍干预治疗提供有效的依据。方法选取我院于2015年9月到2016年8月收治的颅脑损伤患者120例。入院当天行格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分选出中度颅脑损伤患者,并于第2天对其选出患者应用简易精神状态检查表(Mini-mental state examination,MMSE)进行认知功能的评定,根据GCS评分及MMSE结果选出中度颅脑损伤并伴认知障碍患者48例,并将其随机分为奥拉西坦治疗组和常规治疗组,对两组治疗结果对比,并应用统计学进行分析。同时对2组血清IGF-1浓度水平采用ELISA法进行测定。进而对其所得结果应用统计学分析。结果1.治疗前两组GCS评分比较差异无统计学意义,治疗后两组GCS评分较治疗前均有所改善,差异有统计学意义;治疗7天后,两组之间的GCS评分差异无统计学意义,14天后,治疗组GCS评分明显高于常规组,差异有统计学意义;2.临床治疗7天与治疗2天比较时,两组患者的MMSE评分及血清IGF-1浓度水平有所提高,其差异有统计学意义,临床治疗14天与治疗7天后比较时,两组患者的MMSE评分及血清IGF-1浓度水平提高明显,其差异同样具有统计学意义;治疗2天、7天后,两组之间的MMSE评分及血清IGF-1浓度水平差异无统计学意义,治疗14天后两组相比时,治疗组的MMSE评分及血清IGF-1浓度水平较常规组明显提高,差异有统计学意义;结论1.奥拉西坦治疗与常规治疗对改善颅脑损伤患者认知障碍均有效,但前者疗效优于后者。2.血清IGF-1可作为早期筛查颅脑损伤后认知功能障碍的客观指标,并为临床干预提供有效的信息。
[Abstract]:Background nowadays, the incidence of traumatic brain injury (TBI) is high in China. Many patients with craniocerebral injury have left behind different degrees of cognitive dysfunction after their consciousness recovery. Research shows that patients with severe craniocerebral injury are less likely to reintegrate into society. Patients with mild craniocerebral injury were less likely to be associated with cognitive impairment, so this study was mainly focused on moderate craniocerebral injury patients. In recent years, probiotics have been gradually used in the disease. The representative drug oxetam is a new synthetic derivative of 纬 -aminobutyric acid, which plays a major role in the cortex, hippocampus and other parts of the brain, and can not only promote learning and memory, but also improve the ability of learning and memory. A central nervous system drug that protects, activates, and promotes the functional recovery of nerve cells. Objective to explore the effect of olaxetam on cognitive impairment in patients with moderate craniocerebral injury, and to provide some theoretical basis and new ideas for the clinical treatment of cognitive dysfunction in patients with moderate traumatic craniocerebral injury. To provide an effective basis for the intervention treatment of cognitive impairment. Methods 120 patients with craniocerebral injury admitted in our hospital from September 2015 to August 2016 were selected. On the day of admission, Glasgow coma scale was used to select patients with moderate craniocerebral injury, and the cognitive function of the selected patients was evaluated by mini-mental state examination on the second day. According to the results of GCS and MMSE, 48 patients with moderate craniocerebral injury with cognitive impairment were randomly divided into two groups: oxiracetam treatment group and routine treatment group. The results of the two groups were compared and statistically analyzed. At the same time, the level of serum IGF-1 was measured by ELISA method. Then statistical analysis was applied to the results obtained. Result 1. There was no significant difference in GCS scores between the two groups before treatment, but there was no significant difference in GCS scores between the two groups after treatment, and there was no significant difference in GCS scores between the two groups after 7 days of treatment. The GCS score of the treatment group was significantly higher than that of the routine group, and the difference was statistically significant. The MMSE score and serum IGF-1 level of the two groups were significantly higher than that of the two groups on the 7th day and the 2nd day after the treatment, and the difference was statistically significant between 14 days and 7 days after treatment. The MMSE score and serum IGF-1 level of the two groups were significantly increased, and the difference was also statistically significant, but there was no significant difference in MMSE score and serum IGF-1 level between the two groups after 2 days and 7 days of treatment. After 14 days of treatment, the MMSE score and serum IGF-1 level in the treatment group were significantly higher than those in the conventional group, and the difference was statistically significant. Conclusion 1. Both olaxetam and routine therapy were effective in improving cognitive impairment in patients with craniocerebral injury, but the former was better than the latter. Serum IGF-1 can be used as an objective index for early screening of cognitive dysfunction after craniocerebral injury and provide effective information for clinical intervention.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.15

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