目的 觀察注射用丹參多酚酸對(duì)卒中后認(rèn)知障礙患者血清細(xì)胞間黏附分子-1（ICAM-1）、血管細(xì)胞粘附分子-1（VCAM-1）、β-淀粉樣蛋白（Aβ）-42水平和蒙特利爾認(rèn)知評(píng)估量表（MoCA）評(píng)分的影響。方法 選取2018年1月—2019年4月河南大學(xué)第一附屬醫(yī)院住院的102例卒中后認(rèn)知功能障礙患者作為研究對(duì)象。根據(jù)隨機(jī)數(shù)字表方法，將患者分為對(duì)照組和觀察組，每組各51例。對(duì)照組靜脈滴注注射用血塞通，400 mg加入生理鹽水250 mL，1次/d；觀察組靜脈滴注注射用丹參多酚酸，130 mg加入生理鹽水250 mL，1次/d。兩組患者均治療2周。比較治療前后兩組患者血清細(xì)胞間黏附分子-1（ICAM-1）、血管細(xì)胞粘附分子-1（VCAM-1）、β-淀粉樣蛋白（Aβ）-42水平和蒙特利爾認(rèn)知評(píng)估量表（MoCA）評(píng)分。結(jié)果 與治療前的水平相比，對(duì)照組Aβ-42水平顯著降低，觀察組的ICAM-1、VCAM-1和Aβ-42血清水平大幅下降，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組的ICAM-1、VCAM-1血清水平與對(duì)照組相比顯著下降，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組MoCA評(píng)分顯著升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后觀察組MoCA量表評(píng)分顯著高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 注射用丹參多酚酸對(duì)腦卒中后認(rèn)知功能障礙患者的血清ICAM-1、VCAM-1水平有改善作用，并能減少Aβ-42的生成，提高其認(rèn)知功能。

Objective To observe the effect of Salvianolate for injection on serum ICAM-1,VCAM-1, and Aβ-42 levels and MoCA score in patients with post-stroke cognitive impairment. Methods Patients (102 cases) with post-stroke cognitive impairment in the First Affiliated Hospital of Henan University from January 2018 to April 2019 were divided into control group and observation group acccording to random number table method, and each group had 51 cases. Patients in the control group were iv administered with Xuesaitong Injection, 400 mg were added into 250 mL saline, once daily. Patients in the observation group were iv administered with Salvianolate for injection, 130 mg were added into 250 mL saline, once daily. Patients in two groups were treated for 2 weeks. The levels of ICAM-1, VCAM-1, Aβ-42, and MoCA score in two groups before and after treatment were compared. Results Compared with the level of before treatment, Aβ-42 in the control group were decreased significantly, and the serum levels of ICAM-1, VCAM-1 and Aβ-42 in the observation group were decreased significantly, with significant difference before and after treatment in the same group (P < 0.05). The serum levels of ICAM-1 and VCAM-1 in the observation group were decreased significantly compared with those in the control group, and the difference between two groups was significant (P < 0.05). After treatment, the MoCA score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the MoCA score in the observation group was significantly higher than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Salvianolate for injection can improve the serum levels of ICAM-1 and VCAM-1 in patients with post-stroke cognitive impairment, reduce the generation ofAβ-42, and improve its cognitive function.

R969.4

河南省醫(yī)學(xué)科技攻關(guān)項(xiàng)目（2017T02048）