目的 探讨艾地苯醌联合康复训练对老年血管性痴呆（VD）患者认知功能及血浆神经递质的影响。 方法 66例老年VD患者随机分为联合组（n=33）、对照组（n=33）。对照组给予艾地苯醌片治疗，3 次/d，1 片/次，联合组在此基础上给予系统性的康复训练，包括记忆力训练、注意力训练、定向障碍训练、运动训练、心理训练等，共持续3 m。比较两组MMSE、ADL的改善情况及血浆神经递质的水平变化。 结果 干预后，两组MMSE评分均有不同程度的改善，且联合组除了语言理解外，定向力、即刻记忆、注意力和计算力、延迟记忆、视空间及总评分均明显高于对照组（P〈0.05）。干预后，联合组、对照组BI指数明显改善，且联合组的改善的幅度明显优于对照组（P〈0.05）。干预后，两组NE、DA、5-HT明显升高，且联合组的升高的幅度明显优于对照组（P〈0.05）。 结论 艾地苯醌联合脑部康复训练可促进老年VD患者神经功能恢复，改善认知功能，改善神经递质水平。
Objective To explore the influence of rehabilitation training combined with idebenone on cognitive function and plasma neurotransmitter for elderly patients with vascular dementia （VD）. Methods 66 elderly patients with VD were randomly divided into combined group （n=33）,control group （n=33）. Control group was given idebenone,3 times per day,1 piece per time. On this basis,combined group was given rehabilitation training including memory training,concentration training,disorientation training,sports training,psychological training for 3 months. The improvement of MMSE,ADL and change of plasma neurotransmitter between two groups were compared. Results After intervention,the MMSE scores had different degrees of improvement,and the orientation,immediate memory,attention and calculation forces,delayed memory,visual space and total score in combined group were significantly higher than those in control group except language comprehension（P〈0.05）. BI index in both combined group and control group after intervention was improved significantly,and the extent of improvement in combined group was obviously better than that of control group （P〈0.05）. After intervention,the levels of NE,DA and 5-HT were increased significantly,and increase amplitude in combined group was obviously better than that of control group（P〈0.05）. Conclusion Rehabilitation training combined with idebenone for elderly patients with VD can promote nerve functional recovery,improve cognitive function and the levels of neurotransmitter.
Journal of Apoplexy and Nervous Diseases
Vascular dementia；Elderly；Idebenone；Rehabilitation training；Cognitive function；Neurotransmitter