Abstract: Objective　To explore the clinical value of butylphthalide combined with idebenone in the treatment of elderly patients with vascular dementia. Methods　The retrospective analysis selected 165 elderly patients with vascular dementia admitted to Hebi Chaoyang Ren'ai Hospital from January 2020 to June 2021 as the research objects. After analyzing the patients' medical records, all patients were divided into a control group (82 cases) and a study group (83 cases) according to different medication regimens. There were 42 males and 40 females in the control group, aged (69.27±2.51) years; there were 44 males and 39 females in the study group, aged (69.50±2.76) years. The control group received butylphthalide treatment, the study group received butylphthalide combined with idebenone treatment, and both groups were treated for 2 months. The carotid peak systolic velocity (PSV), Montreal Cognitive Assessment Scale (MoCA) score, resistance index (RI), Stroke Special Quality of Life Scale (SS-QOL) score, and end diastolic velocity (EDV) before and after treatment and adverse reactions were compared between the two groups. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　The MoCA score of the study group after treatment was higher than that of the control group [(23.43±2.75) points vs. (19.79±2.91) points], with a statistically significant difference (P<0.05). Before treatment, there were no statistically significant differences in the carotid hemodynamic indexes between the two groups (all P>0.05); after treatment, the EDV and PSV of the study group were (19.93±4.96) cm/s and (75.95±10.25) cm/s, respectively, higher than those of the control group [(17.55±5.21) cm/s and (70.16±15.16) cm/s], the RI was (0.60±0.07), lower than that of the control group [(0.66±0.17)], with statistically significant differences (all P<0.05). Before treatment, there was no statistically significant difference in the SS-QOL score between the two groups (P>0.05); after treatment, the scores of self-care ability, physical state, psychological state, and life impact of SS-QOL of the study group were (49.35±8.16) points, (52.35±9.44) points, (39.86±6.28) points, and (40.13±5.52) points, respectively, which were higher than those of the control group [(43.55±7.84) points, (46.61±8.93) points, (34.34±6.55) points, and (35.41±6.15) points], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion　Butylphthalide combined with idebenone can effectively improve the hemodynamic indexes of cerebral artery in elderly patients with vascular dementia, and improve their quality of life and MoCA score.

Key words: Vascular dementia, Elderly patients, Butylphthalide, Idebenone, Hemorheology

摘要： 目的　探讨丁苯酞联合艾地苯醌治疗血管性痴呆老年患者的临床价值。方法　回顾性分析，选取鹤壁朝阳仁爱医院2020年1月至2021年6月收治的165例血管性痴呆老年患者作为研究对象，分析患者病历资料后根据用药方案的不同将所有患者分为对照组（82例）和研究组（83例）。对照组男42例、女40例，年龄（69.27±2.51）岁；研究组男44例、女39例，年龄（69.50±2.76）岁。对照组接受丁苯酞治疗，研究组接受丁苯酞联合艾地苯醌治疗，两组患者均治疗2个月。对比两组治疗前后的颈动脉收缩期峰值流速（PSV）、蒙特利尔认知评估量表（MoCA）评分、阻力指数（RI）、脑卒中专用生活质量量表（SS-QOL）评分、舒张末期流速（EDV）及不良反应。计量资料组间比较采用独立样本t检验，组内采用配对t检验，计数资料采用χ²检验。结果　治疗后，研究组的MoCA评分为（23.43±2.75）分，高于对照组的（19.79±2.91）分，差异有统计学意义（P<0.05）。治疗前，两组血管性痴呆老年患者颈动脉血液动力学指标比较，差异均无统计学意义（均P>0.05）；治疗后，研究组的EDV、PSV指标分别为（19.93±4.96）cm/s、（75.95±10.25）cm/s，均大于对照组（17.55±5.21）cm/s、（70.16±15.16）cm/s，RI为（0.60±0.07），小于对照组（0.66±0.17），差异均有统计学意义（均P<0.05）。治疗前，两组血管性痴呆老年患者SS-QOL评分比较，差异均无统计学意义（均P>0.05）；治疗后，研究组自理能力、身体状态、心理状态、生活影响评分分别为（49.35±8.16）分、（52.35±9.44）分、（39.86±6.28）分、（40.13±5.52）分，均高于对照组（43.55±7.84）分、（46.61±8.93）分、（34.34±6.55）分、（35.41±6.15）分，差异均有统计学意义（均P<0.05）。两组血管性痴呆老年患者不良反应比较，差异无统计学意义（P>0.05）。结论　丁苯酞联合艾地苯醌可有效改善血管性痴呆老年患者脑供血动脉血液流变学指标，提高患者生活质量及MoCA评分。

关键词: 血管性痴呆, 老年患者, 丁苯酞, 艾地苯醌, 血液流变学