Objective:To observe the curative effect of nimodipine combined with oxiracetam in the treatment of cognitive impairment after cerebral infarction and the influence on cognitive function.Methods:110 patients with cognitive impairment after cerebral infarction were randomly divided into the observation group and the control group,with 55 cases in each group.All patients were given routine treatments such as regulating blood glucose,controlling blood pressure,anti-platelet aggregation,statin,relieving cerebral edema,reducing intracranial pressure and nutritional support.On the basis,the control group were treated with oxiracetam while the observation group were treated with nimodipine combined with oxiracetam.The dynamical parameters of cerebral circulation were detected,and the cognitive function and quality of life were evaluated.The incidence of adverse reactions was statistically analyzed.Results:Plasma specific viscosity,fibrinogen and hematocrit were significantly lower in the two groups than before treatment (P ＜ 0.05).After 6 months of treatment,scores of Mini-mental State Examination (MMSE),Montreal cognitive assessment (MOCA) and quality of life score (BI)were significantly higher than those in the control group [(27.39±4.93),(24.70±4.45),(83.19±14.98) vs.(24.94 ±4.49),(22.88 ± 4.11),(75.63 ± 13.61)] (P ＜ 0.05),and the score of the National Institutes of Health Stroke Scale (NIHSS) was significantly lower than that in the control group [(4.52 ± 0.83) vs.(5.02 ± 0.91)] (P ＜ 0.05).Conclusion:Nimodipine combined with oxiracetam can improve the blood circulation and promote cognitive function recovery in patients with cognitive impairment after cerebral infarction.

Objective To evaluate the effects and safety of combined treatment with argatroban and aspirin in acute posterior circulation cerebral infarction. Method 92 patients with posterior circulation cerebral infarction treated in our hospital from January 2013 to December 2015 were selected as the subjects, they were randomly divided into three groups, including simple anti-platelet group, combined anti-platelet group and observed group by sortitio n, which were respectively given aspirin, aspirin and clopidogrel, argatroban and asprin. After 7 days, all patients changed to use aspirin simply. National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) were taken to evaluate the neurological function and living ability at admission (48 hours after disease onset), 1 week and 1 month after treatment. Blood platelet (PLT), activated partialthromboplastin time (APTT) and international normalized ratio (INR) were examined at admission and 1 week after treatment. Result There were no significant differences in NIHSS scores and BI scores at admission among the three groups (P>0.05). 1 week after treatment, the NIHSS score of observation group was significantly lower than simple anti-platelet group and combined anti-platelet group (P = 0.014, P =0.039);the BI score of observation group was significantly higher than simple anti-platelet group (P=0.020), and there was no significant difference in BI score between observation group and combined anti-platelet group (P>0.05). 1 month after treatment, the NIHSS score of observation group and combined anti-platelet group were lower than simple anti-platelet group (P = 0.010, P < 0.001), the NIHSS score of observation group was lower than combined anti-platelet group (P = 0.031). The BI score of observation group and combined anti-platelet group were significantly higher than simple anti-platelet group (P=0.025, P=0.017), and the BI score of observation group was higher than combined anti-platelet group (P = 0.046). Within 1 week after treatment, there was no bleeding event in simple anti-platelet group, combined anti-platelet group and observation group of 1 case of patients with bleeding events, but the two groups of patients with bleeding events was not significant difference (χ2=0.001, P=0.999). There were no significant differences in PLT, APTT and INR among the three groups after admission and 1 week after treatment (F=1.416, P=0.248). Conclusion The effects of combined treatment with argatroban and aspirin in posterior circulation cerebral infarction is better than both asprin simple anti-platelet treatment and combined anti-platelet treatment with aspirin and clopidogrel, also with satisfied safety.

欧洲卒中组织(ESO)于2008年5月更新了欧洲卒中促进会(EUSI)2000和2003版的缺血性卒中和短暂性脑缺血发作的治疗指南.2008版指南包含了2003年以来的新进展.本文编译了2008版指南中的主要建议.