目的 探究神經(jīng)節(jié)苷酯聯(lián)合氯吡格雷治療腦梗死后血管性癡呆的臨床療效。方法 選取2014年10月-2015年10月在中國人民解放軍第三軍醫(yī)大學(xué)第一附屬醫(yī)院接受治療的腦梗死后血管性癡呆患者126例，隨機(jī)分為對照組和治療組，每組各63例。對照組患者口服硫酸氫氯吡格雷片，75 mg/次，1次/d；治療組在對照組的基礎(chǔ)上靜脈滴注單唾液酸四己糖神經(jīng)節(jié)苷脂鈉注射液，100 mg/次，1次/d，兩組患者均治療3個(gè)月。觀察兩組的臨床療效，比較兩組治療前后的簡易智力狀態(tài)檢查量表評分、日常生活能力量表評分和臨床癡呆評定量表評分及其不良反應(yīng)情況。結(jié)果 治療后，對照組和治療組的總有效率分別為76.19%、96.83%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者簡易智力狀態(tài)檢查量表評分明顯升高，日常生活能力量表評分和臨床癡呆評定量表評分均明顯降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后治療組簡易智力狀態(tài)檢查量表評分明顯高于對照組，治療組日常生活能力量表評分和臨床癡呆評定量表評分明顯低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組不良反應(yīng)發(fā)生情況比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 神經(jīng)節(jié)苷酯聯(lián)合氯吡格雷治療腦梗死后血管性癡呆的療效顯著，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of ganglioside combined with clopidogrel in treatment of vascular dementia after cerebral infarction. Methods Patients (126 cases) with vascular dementia after cerebral infarction in the First Affiliated Hospital of Third Military Medical University from October 2014 to October 2015 were randomly divided into control and treatment groups, and each group had 63 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were iv administered with Monosialotetrahexosylganglioside Sodium Injection, 100 mg/time, once daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and simple intelligence status scale, the daily life ability scale, the clinical dementia rating scale, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.19% and 96.83% respectively, and there was difference between two groups (P < 0.05). After treatment, the scores of simple intelligence status scale were significantly increased, but the scores of the daily life ability scale and the clinical dementia rating scale were significantly decreased, the difference was statistically significant in the same group (P < 0.05). And the scores of simple intelligence status scale, daily life ability scale, and clinical dementia rating scale were significantly better than those in the control group, with significant difference between two groups (P < 0.05). There was no significant difference in adverse reactions between two groups. Conclusion Gangliosides combined with clopidogrel has a significant curative effect in treatment of vascular dementia after cerebral infarction with good safety, which has a certain clinical application value.