Abstract:

Objective　To explore the effect of cerebral circulation therapy on cognitive function and activities of daily living in elderly patients with cerebral infarction. Methods One hundred and thirty-one elderly (≥65 years old) patients with cerebral infarction hospitalized in Department of Neurology, Lianyungang Second People's Hospital from October 2017 to September 2019 were enrolled and divided into a control group and an observation group by the random number table method. The control group were treated with conventional drugs and rehabilitation therapy; in addition, the observation group took cerebral circulation therapy once per day and 5 times per week for 2 consecutive weeks. The patients were followed up to 90 days after onset. The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate their cognitive function. The Fugl-Meyer Motor Function Score (FMA) was used to evaluate their motor function. The Barthel Index (BI) was used to evaluate their activities of daily living. The modified Rankin Scale (mRS) was used to assess their prognosis. Independent-sample t, Mann-Whitney U, and χ² tests were used to compare the data between the groups. Results　Among the 131 patients, 2 were out of the follow up and 1 died; at last, 128 finished the 90-day follow up, including 63 cases in the observation group and 65 cases in the control group. The 90-day follow up showed that the scores of MoCA, FMA, and BI in the observation group were higher than those in the control group [(19.08±2.93) vs. (15.83±2.62), (73.59±5.90) vs. (67.42±7.66), and (69.63±7.89) vs. (66.23±6.45)], with statistical differences (all P<0.01). The proportion of the patients with good prognosis (mRS score ≤ 2) in the observation group was higher than that in the control group [82.5% (52/63) vs. 61.5% (40/65); χ²=4.313, P=0.038]. There were no serious adverse reactions in both groups. Conclusion　Cerebral circulation therapy has certain effect on cognitive function and motor function in elderly patients with cerebral infarction, and can improve their activities of daily living and prognosis.

Key words:

Cerebral infarction, The elderly, Cerebral circulation therapy, Cognitive function, Activities of daily living, Prognosis

摘要：

目的　探讨脑循环治疗对老年脑梗死患者认知功能及日常生活活动能力的疗效。方法　前瞻性纳入2017年10月至2019年9月在连云港市第二人民医院神经科住院治疗的老年（≥65岁）脑梗死患者131例，随机数字表法分成对照组和观察组。对照组采用常规药物和康复治疗，观察组在对照组的基础上联合脑循环治疗（1次/d，5次/周，连续2周，共治疗10 d）。所有研究对象随访至发病后90 d。采用蒙特利尔认知评估量表（MoCA）评估患者的认知功能，Fugl-Meyer运动功能评分（FMA）评估患者的运动功能，Barthel指数（BI）评价患者的日常生活活动能力，改良Rankin量表（mRS）评估患者的预后。组间比较采用独立样本t检验、Mann-Whitney U检验、χ²检验。结果　在纳入的131例患者中，失访2例，死亡1例，最终128例完成90 d随访，观察组63例，对照组65例。90 d随访发现，观察组MoCA、FMA、BI评分分别为（19.08±2.93）分、（73.59±5.90）分、（69.63±7.89）分，均高于对照组［（15.83±2.62）分、（67.42±7.66）分、（66.23±6.45）］，差异均有统计学意义（均P<0.01）；观察组预后良好（mRS评分≤2分）的患者比例明显高于对照组［82.5%（52/63）比61.5（40/65），χ²=4.313，P=0.038］；两组均无严重不良反应。结论　脑循环治疗对老年脑梗死患者认知功能及运动功能有一定的疗效，可提高患者的日常生活活动能力，改善患者预后。

关键词:

脑梗死, 老年, 脑循环治疗, 认知功能, 日常生活活动能力, 预后