| Objective1.To study the correlation between post-stroke cognitive impairment and acute cerebral infarction focus and the brain structure.2.To observe the clinical effect of Erigeron Breviscapus Injection on cognitive function changes after treatment of acute stroke with cognitive impairment。Method1.There were 149 patients with acute cerebral infarction scored by MMSE.They were divided into cognitive normal group and cognitive impairment group.The characteristics of infarction focus were compared between the two groups.The results of seven sub-items of MMSE measured in different parts of stroke(single lesion)were analyzed and 16 patients with obvious cognitive impairment were selected as subjects.In the experimental group,the brain structure was analyzed with 12 healthy volunteers to explore the relationship between cognitive impairment and the brain structure after stroke.2.Sixty patients with acute cerebral infarction who met the inclusion criteria were divided into two groups according to the diagnostic criteria of cognitive impairment after stroke: group A: routine western medicine treatment + breviscapine injection;group B: routine western medicine treatment + edaravone injection.The course of treatment was 2 weeks.We will do some neuropsychological Scales and blood biochemical tests were performed before and after treatment.Results1.Compared with the normal cognitive group,the total score of MMSE scale and the cognitive level of each sub-item in different infarction focus groups had statistical significance(P<0.05).Among them,the orientation,immediate recall,delayed recall,calculation and attention,damaged visual space was obvious in patients with thalamic infarction,time orientation impairment was obvious in patients with basal ganglia infarction,and computing power and attention in patients with lateral ventricular infarction.Intentional power,delayed memory,language and visual space impairment were obvious;immediate memory,delayed memory and language impairment were obvious in patients with frontal infarction;immediate memory,language and visual space impairment were more obvious in patients with temporal infarction;location orientation and language impairment were obvious in patients with parietal infarction;visual space impairment was obvious in patients with occipital infarction;visual space impairment might be obvious in patients with cerebellar infarction;visual space and brain impairment might be obvious in patients with cerebral infarction.Dry infarction may be associated with impairment of immediate recall,attention and computational ability,and delayed recall.2.Compared with the normal control group,gray matter and cerebrospinal fluid in the cognitive impairment group were significantly reduced after brain tissue segmentation based on VBM,with statistically significant differences(P < 0.05).There was no difference between white matter and the cognitive normal group.After correction with FDR of 58 and P=0.001,all the selected brain areas showed atrophy,and no gray matter increase was observed.The brain areas with obvious atrophy included middle frontal gyrus,middle temporal gyrus,hippocampal lingual gyrus,anterior cerebellar lobe,posterior cerebellar lobe,anterior central gyrus and cingulate gyrus.3.Compared with the control group before and after treatment,there was no significant difference in the number of StroopA color words in the observation group and the time of StroopB color words in the control group.There were significant differences in MMSE,digital breadth,experiment of clock drawing,connection,ADL score,NIHSS score and the improved Rankine scale before and after treatment(P<0.05).Both the observation group and the control group could improve the cognitive impairment of patients with neurological deficits after two weeks of treatment.However,compared with the control group,the observation group had a unified MMSE,StroopA color time,Stroop A color number,Stroop B color number,digital breadth-total number,connection 1 time,connection 1 error number,connection 2 error number,experiment of clock drawing.There was no significant difference in the related indicators of neurological impairment between the two groups(ADL,NIHSS score and modified Rankine scale)(P>0.05).Conclusion1.The occurrence of cognitive impairment after acute cerebral infarction is closely related to the location of stroke.2.2.Changes in brain structure and morphology may be an important cause of cognitive impairment.3.Erigeron breviscapus injection is safe and effective in the treatment of cerebral infarction.It can not only improve the symptoms of neurological impairment,reduce the disability rate,but also improve the cognitive impairment and improve the quality of life of patients. |
PDF Full Text Request