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临床医学研究与实践 2022 年 4 月第 7 卷第 10 期Effect of escitalopram combined with piracetam in the treatment ofpost-stroke cognitive impairment and its influences onserum 5-HT and NE levels of patientsLIU Juan, ZHENG Xiaojun, WANG Ying, LIU Xiaoliang*(No.2 Neurology Department, Baoji People's Hospital, Baoji 721000, China)ABSTRACT: Objective To investigate the clinical effect of escitalopram combined with piracetam in the treatment ofpost-stroke cognitive impairment (PSCI). Methods A total of 96 patients with PSCI treated in our department fromFebruary 2019 to December 2020 were selected as the research objects. The patients were divided into control group andobservation group according to the random number table method, with 48 cases in each group. The control group wastreated with piracetam, and the observation group was treated with escitalopram combined with piracetam. The clinicaleffects of the two groups were compared. Results The total effective rate of treatment in the observation group was higherthan that in the control group, and the difference was statistically significant (P<0.05). After treatment, the levels ofserum NE and 5-HT in the two groups increased, those in the observation group were higher than the control group, andthe differences were statistically significant (P<0.05). After treatment, the levels of BDNF and NSE in the two groupsimproved, those in the observation group were better than the control group, and the differences were statisticallysignificant (P<0.05). After treatment, the HAMA and HAMD scores in the two groups decreased, those in the observationgroup were lower than the control group, and the differences were statistically significant (P<0.05). After treatment, thescores of BI, MoCA and NIHSS in the two groups improved, those in the observation group were better than the controlgroup, and the differences were statistically significant (P<0.05). After treatment, the SIS scores in the two groupsincreased, those in the observation group were higher than the control group, and the differences were statisticallysignificant (P<0.05). Conclusion Escitalopram combined with piracetam in the treatment of patients with PSCI has asignificant effect, it can improve the levels of NE, 5-HT and BDNF, reduce the level of NSE, improve the anxiety anddepression, ability of daily living, cognitive and neurological function, and ameliorate the quality of life of patients, whichis worthy of clinical promotion and application.KEYWORDS: escitalopram; piracetam; post-stroke cognitive impairment; neurological function; anxiety; depression艾司西酞普兰联合吡拉西坦治疗卒中后认知功能障碍的效果及对患者血清 5-HT 及 NE 水平的影响刘娟，郑小军，王英，刘晓亮*（陕西省宝鸡市人民医院神经内二科，陕西 宝鸡，721000）DOI: 10.19347/j.cnki.2096-1413.202210015作者简介：刘娟（1976— ），女，汉族，陕西武功人，副主任医师，学士。研究方向：眩晕、睡眠障碍、焦虑、抑郁及脑血管病的诊治。* 通讯作者：刘晓亮，E-mail:2541633740@qq.com.摘要： 目的 探讨艾司西酞普兰联合吡拉西坦治疗卒中后认知功能障碍（PSCI）的临床效果。方法 选取 2019 年 2 月至2020 年 12 月我科室收治的 96 例 PSCI 患者作为研究对象，按照随机数表法将其分为对照组与观察组，每组 48 例。对照组采用吡拉西坦治疗，观察组采用艾司西酞普兰联合吡拉西坦治疗。比较两组患者的临床效果。结果 观察组的治疗总有效率高于对照组，差异具有统计学意义（P<0.05）。治疗后，两组的血清 NE 及 5-HT 水平均升高，且观察组高于对照组，差异具有统计学意义（P<0.05）。治疗后，两组的 BDNF 及 NSE 水平均改善，且观察组优于对照组，差异具有统计学意义（P<0.05）。治疗后，两组的 HAMA 及 HAMD 评分均降低，且观察组低于对照组，差异具有统计学意义（P<0.05）。治疗后，两组的 BI、MoCA 及 NIHSS 评分均改善，且观察组优于对照组，差异具有统计学意义（P<0.05）。治疗后，两组的SIS 各项评分均升高，且观察组高于对照组，差异具有统计学意义（P<0.05）。结论 艾司西酞普兰联合吡拉西坦治疗PSCI 患者的效果显著，可提高 NE、5-HT 及 BDNF 水平，降低 NSE 水平，改善患者的焦虑、抑郁情绪、日常生活能力及认知、神经功能，提高其生活质量，值得临床推广应用。关键词： 艾司西酞普兰；吡拉西坦；卒中后认知功能障碍；神经功能；焦虑；抑郁中图分类号： R743.3 文献标志码： A 文章编号： 2096-1413(2022)10-0054-04临床医学脑卒中是中老人常见的一种疾。渲滤缆矢，预后差，治愈后患者常会伴有不同程度的认知功能障碍，即卒中后认知功能障碍（post-stroke cognitive impairment, PSCI）。PSCI 易使患者出现焦虑、抑郁等不良情绪，进而不利于疾54 - -