Abstract: Objective To investigate the efficacy and safety of ginkgo biloba combined with oxiracetam in patients with vascular cognitive impairment no dementia (VCIND). Methods 102 patients with VCIND were enrolled in our hospital (October 2016-June 2018). The random number table method was used to divide them into control group (n=51) and study group (n=51). On the basis of routine intervention, oxiracetam was taken in the control group for two weeks, and the research group was given Ginkgo biloba leaves on the basis of the control group for 3 months. Serum glycosylation end product receptor soluble fragment (sRAGE), β-site APP-cleaving enzyme 1 (BACE1) level, daily living ability (ADL), menory function (WMSscore)cognitive function (MoCA) and mental status (MMSE) scores, regional cerebral blood flow, adverse reactions (vomiting nausea, dizziness, rash) were compared. Results In terms of clinical efficacy, the total effective rate of the study group (94.12%) was higher than that of the control group (80.39%) (P<0.05). After the course of treatment, the serum sRAGE of the two groups was higher than that before treatment, and the level of BACE1 was lower than that before treatment. The sRAGE of the study group was higher than that of the control group, and BACE1 was lower than that of the control group. After the course of treatment, the scores of ADL, WMS, MoCA and MMSE in the two groups were higher than those before treatment, and the regional cerebral blood flow in the study group was higher than that before treatment, and the regional cerebral blood flow in the study group was higher than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the study group (11.76%) and the control group (7.84%). Conclusion The combination of oxiracetam and ginkgo leaves for the treatment of VCIND can effectively regulate serum sRAGE and BACE1 levels, improve cognitive function, memory function and mental state, restore daily living ability, increase regional cerebral blood flow, and improve disease overall treatment.

Key words: vascular cognitive impairment-dementia, Ginkgo leaf, oxiracetam, sRAGE, BACE1, ADL, WMS, MoCA, MMSE

摘要： 目的 探讨银杏叶片联合奥拉西坦在非痴呆性血管认知障碍（VCIND）患者中应用效果与安全性。方法 选取我院VCIND患者102例,随机数字表法分为对照组（n=51）与研究组（n=51）。常规干预基础上对照组采取奥拉西坦治疗2周,研究组于对照组基础上加用银杏叶片治疗3个月。统计两组临床疗效、治疗前及疗程结束后的血清糖基化终末产物受体可溶性片段（sRAGE）浓度、淀粉蛋白前β位分解酶1（BACE1）水平、日常生活能力（ADL）、记忆功能（WMS评分）、认知功能（MoCA）及智力状态（MMSE）评分、局部脑血流量、不良反应（呕吐恶心、头晕、皮疹）发生率。结果 在临床疗效方面,研究组总有效率（94.12%）高于对照组（80.39%）（P<0.05）;疗程结束后两组血清sRAGE较治疗前增高,BACE1水平较治疗前降低,且研究组sRAGE高于对照组、BACE1低于对照组（P<0.05）;疗程结束后两组ADL、WMS、MoCA、MMSE分值较治疗前增高,且研究组高于对照组（P<0.05）;疗程结束后两组局部脑血流量较治疗前增大,且研究组大于对照组（P<0.05）;研究组不良反应发生率（11.76%）与对照组（7.84%）间无显著差异（P>0.05）。结论 联合采取奥拉西坦及银杏叶片治疗VCIND可有效调节血清sRAGE及BACE1水平,改善患者认知功能、记忆功能与智力状态,恢复日常生活能力,增大局部脑血流量,利于提高疾病整体治疗效果。

关键词: 非痴呆性血管认知障碍, 银杏叶片, 奥拉西坦, sRAGE, BACE1, ADL, WMS, MoCA, MMSE