Résumé
Objective:To investigate the changes in cognitive and behavioral function in patients with cerebral small vessel disease and their correlation with serum homocysteine (Hcy) and cystatin C (CysC) levels.Methods:Ninety-four patients with cerebral small vascular disease who received treatment in Zhejiang Xin'an International Hospital from March 2019 to March 2021 were included in the observation group. An additional 80 healthy controls who concurrently received physical examination were included in the control group. The Mini-Mental State Scale (MMSE) and the Montreal Assessment Scale (MoCA) were used to evaluate cognitive function. The activity of daily living (ADL) was used to evaluate behavioral function. Enzyme-linked immunosorbent assay was used to measure serum Hcy and CysC levels. MMSE score, MoCA score, ADL score, serum Hcy and CysC levels were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of serum Hcy and CysC levels in the diagnosis of cerebral small vessel disease. Pearson correlation analysis was performed to analyze the correlation between serum Hcy and CysC levels and cognitive behavioral function.Results:MMSE score, MoCA score, and ADL score in the observation group were (21.21 ± 2.87) points, (20.18 ± 3.25) points, and (34.32 ± 5.45) points, which were significantly lower than (28.23 ± 1.02) points, (28.45 ± 0.89) points and (76.35 ± 8.29) points in the control group ( t = 20.78, 22.05, 40.03, all P < 0.05). Serum Hcy and CysC in the observation group were (16.28 ± 2.97) μmol/L and (1.21 ± 0.23) mg/L, which were significantly higher than (8.35 ± 1.76) μmol/L and (0.56 ± 0.12) mg/L in the control group ( t = 20.95, 22.77, both P < 0.05). ROC curve analysis showed that the sensitivity and specificity of serum Hcy in diagnosing cerebral small vessel disease were 85.29% and 53.85%, respectively; the sensitivity and specificity of serum CysC in diagnosing cerebral small vessel disease were 81.54% and 41.38%, respectively. Pearson correlation analysis revealed that serum Hcy level was linearly negatively correlated with MMSE score, MoCA score, and ADL score ( r = -0.79, -0.68, -0.71, all P < 0.05); serum CysC level was linearly negatively correlated with MMSE score, MoCA score, and ADL score ( r = -0.67, -0.75, -0.78, P < 0.05). Conclusion:The cognitive and behavioral function of patients with cerebral small vessel disease are decreased, and serum Hcy and CysC levels are increased. Serum Hcy and CysC levels are closely related to the cognitive and behavioral function of patients with cerebral small vessel disease.
Résumé
Objective To investigate the clinical effect of edaravone combined with ginkgo leaf extract and dipyridamole injection in the treatment of acute cerebral infarction.Methods From January 2016 to September 2017,100 patients with acute cerebral infarction in Xin'an International Hospital were selected.According to digital table method,the patients were divided into observation group and control group,with 50 cases in each group.The observation group was given edaravone combined with ginkgo leaf extract and dipyridamole injection.The control group received ginkgo leaf extract and dipyridamole injection treatment.The patients were treated for 20 days.The clinical effect of the two groups was compared.Results The total effective rate of the observation group was 90.0％,which was significantly higher than 70.0％ in the control group (x2 =16.265,P ＜ 0.05).Before treatment,the whole high blood viscosity,whole low blood viscosity,blood plasma viscosity,hematocrit and fibrinogen between the two groups had no statistically significant differences (t =0.156,1.563,0.156,1.563,1.263,all P ＞ 0.05).After treatment,the indicators in the two groups were declined.The whole high blood viscosity,whole low blood viscosity,blood plasma viscosity,hematocrit and fibrinogen in the observation group were (5.29 ± 1.25) mPa/s,(12.88 ± 3.35) mPa/s,(1.76 ± 0.28) mPa/s,(0.44 ± 0.48) and (3.48 ± 0.57) g/L,respectively,which were significantly better than those in the control group[(5.83 ± 1.54) mPa/s,(14.54 ±4.29) mPa/s,(1.89 ±0.32) mPa/s,(0.47 ±0.65),(3.76±0.89) g/L],the differences were statistically significant between the two groups(t =5.423,6.287,5.112,9.145,5.443,all P ＜ 0.05).Conclusion Edaravone combined with ginkgo leaf extract and dipyridamole injection in the treatment of acute cerebral infarction has good effect,and it is worth to be widely used in the clinical treatment.
Résumé
Objective To evaluate the clinical efficacy of ganglioside combined with edaravone in the treatment patients with acute cerebral infarction,to assess the improvement of neurological function and prognosis.To provide the evidence for the clinical treatment of acute cerebral infarction.Methods 126 patients with acute cerebral infarction were selected.According to the digital table,they were randomly divided into the control and the study group,with 65 cases in each group.The control group was given edaravone based on the conventional treatment,the study group was treated with ganglioside and edaravone.The treatment effect was assessed,and the National Institutes of Health Stroke Scale(NIHSS),Fugl -Meyer motor function score,Barthel Index(BI)to assess the improvement of the situation neurological,physical function and daily life were applied.Results The total effective rate of the study group was 82.54%,which was higher than 71.43% of the control group,the difference was statistically significant(χ2 =9.63, P <0.05).The NIHSS score of the study group after treatment was (24.60 ±5.81 )points,which was lower than (27.74 ±5.93)points of the control group,the difference was statistically significant(t =9.97,P <0.05).The FM and BI scores of the study group after treatment were (78.62 ±8.46)points and (72.89 ±8.03)points,which were higher than (73.58 ±8.09)points and (68.30 ±7.45)points of the control group,the differences were statistically significant(t =10.16,11.42,all P <0.05).Conclusion It has better clinical effect on ganglioside and edaravone for the patients with acute cerebral infarction,which can significantly improve neurological function and limb motor function,and significantly improved prognosis of patients.