α-硫辛酸对腔隙性脑梗死伴糖尿病患者认知功能的影响

摘要

目的：观察腔隙性脑梗死伴糖尿病患者的认知功能损害特点，并探讨α‐硫辛酸对其认知功能的影响。方法：伴有糖尿病的腔隙性脑梗死患者60例，随机分配在 A 组（30例，每天静脉使用α‐硫辛酸）和B组（30例，一般治疗）中，对照组（30例）选用健康体检人群。使用蒙特利尔认知评估量表（MOCA）分别对两组患者在发病后3天、3个月进行认知功能评估，并分别与正常对照组进行比较。结果：在脑梗死发病后3天，两组患者均出现视空间与执行功能、命名、延迟记忆、注意力和计算能力、语言、定向功能障碍，总分与对照组相比差异有显著性。在发病后3个月，使用硫辛酸组各项评分较一般治疗组高，总分及注意力、视空间与执行功能、定向力差异有统计学意义。结论：在伴有糖尿病的腔隙性脑梗死患者急性期认知损害广泛，α‐硫辛酸对认知功能具有保护作用。%　　Objective:To explore the characters of cognitive dysfunction for lacunar infarction (L I) with diabetes mellitus and the protective effects of alpha‐lipoic acid .Methods :A total of 64 LI patients with dia‐betes mellitus randomly divided into 2 groups .Patients of group 1 (n=30) were treated with alpha ‐lipoic acid .Patients of group 2(n=30) were assigned conventional therapy .The cognitive function of patients were evaluated with Montreal Cognitive Assessment (MOCA) at 3days and 3months after attack .An additional control group consisted of age‐matched healthy (n=30) .Results:Compared with controls ,significant differ‐ence was found on the memory ,name ,language ,orientation ,attention ,executive function ,visuospatial and visuo‐constructive function at 3 days .Most cognitive domains were improved at 3 months of group 1 ,scores of general MoCA ,attention ,visuospatial and visuo‐constructive function and orientation were higher than those of group 2 (P<0 .05) .Conclusions :In acute stage of LI ,the cognitive impairment was extensive and severe .alpha‐lipoic acid may improve congnitive function .