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OBJECTIVE:To investigate the clinical efficacy and safety of butylphthalide combined with nimodipine in the treat-ment of vascular cognitive impairment. METHODS:Totally 156 patients with vascular cognitive impairment were randomly divided into control group and observation group. All patients were given anti-platelet,control of blood pressure,lowering blood glucose, lowering statin therapy for stable plaque and symptomatic treatment. On this basis,control group was orally treated with nimodipi-he 30 mg,tid;observation group was orally treated with Butylphthalide capsule 0.2 g based on the treatment of control group,tid. The course lasted for 3 months. The clinic data was observed,including clinical efficacy,and Montreal cognitive assessment(Mo-CA)score,activities of daily living scale(ADL)score,stenosis great vessels distal blood flow velocity and incidence of adverse reactions before and after treatment. RESULTS:The total effective rate in observation group was significantly higher than control group,with significant difference(P<0.05). After treatment,the MoCA score,ADL score and stenosis great vessels distal blood flow velocity in 2 groups were significantly higher than before,and observation group was higher than control group,with signifi-cant differences(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,butylphthalide combined with nimodipine has better efficacy than nimodipine alone in the treatment of vascular cognitive impairment,and can improve the stenosis great vessels distal blood flow velocity better,with similar safety.
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Objective To explore the morbidity and risk factors of postoperative delirium in the patients undergoing coronary artery bypass grafting (CABG).Methods A total of 286 patients were continuously enrolled for CABG surgery from January to December 2013 in cardiac surgery ward in Beijing Anzhen Hospital.Delirium Rating Scale-Revised-98 was used as the diagnostic tool for the analysis of the morbidity and risk factors of postoperative delirium.Results (1) Delirium occurred in 24 patients of 286 patients and morbidity of postoperative delirium was 8.4％.Sixteen of 24 patients (66.7％) suffered from transient delirium (＜24 h).Eight of 24 patients (33.3％) suffered from continuous delirium (≥48 h).(2) The common clinical presentation of postoperative delirium included increased psychomotor activity, a disordered sleep-wake cycle and a reduced level of consciousness.(3) Univariate Logistic regression analysis results showed that delirium was associated with advanced age over 70 years old (OR =3.05, 95％ CI 2.55-72.94, P =0.023), previous cerebral infarction(OR =1.78, 95％ CI 1.07-2.96, P =0.026), previous brain heamorrhage (OR =1.99, 95 ％ CI 1.20-3.31, P =0.003), surgery time (OR =1.05, 95％ CI0.05-2.04, P =0.047), intensive care unit (ICU) staying time (OR =2.87, 95％ CI 1.43-5.72, P=0.003), use offentanyl (OR=2.78, 95％ CI 1.02-7.57, P=0.045).(4) The multiple Logistic stepwise regression analysis indicated that the perioperative risk factors of delirium included advanced age over 70 years old (OR =3.196, 95％ CI 1.574-6.488, P =0.001), cerebrovascular accident history(OR =2.610, 95％ CI 1.538-4.431, P =0.000) and ICU duration time(OR =1.480, 95 ％ CI 1.070-2.046, P =0.018).Conclusions The morbidity of postoperative delirium after CABG is 8.4％.Many predisposing and precipitating factors contribute to postoperative delirium.These factors include age ＞ 70 years, cerebral infarction and ICU staying time.Assessment and preventive strategies should be considered to reduce the incidence of delirium, particularly among those patients with high risks.
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0.05). Conclusion:overweight and central obesity influence blood pressure,blood lipid and blood glucose. Lack of exercises is main risk factor in pilots. It is necessary to carry out effective measures for overweighted and central obese pilots to reduce risk of hypertension,diabetes,and abnormal blood lipid.