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[缺血性脑卒中早期恢复期中度认知障碍的治疗]

[Therapy of moderate cognitive impairment in the early recovery period of ischemic stroke].

作者信息

Belova A N, Bogdanov E I, Voznyuk I A, Zhadnov V A, Kamchatnov P R, Kurushina O V, Maslova N N

机构信息

Privolzhsky Research Medical University, Nizhniy Novgorod, Russia.

Kazan State Medical University, Kazan, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(5):33-39. doi: 10.17116/jnevro202112105133.

Abstract

OBJECTIVE

To assess the efficacy and safety of prospecta in the treatment of moderate cognitive impairment in the early recovery period of ischemic stroke.

MATERIAL AND METHODS

The study included 275 patients (mean age 64.0±8.1 years) with a history of single ischemic stroke from 3 to 6 months, with moderate cognitive impairment, and moderate activity in everyday life, who were randomized in two groups. During the screening phase, the severity of cognitive impairment was assessed with the Mini-Mental State Examination and Montreal Cognitive Assessment scales; the level of activity in everyday life was evaluated with the Barthel Scale; and quality of life was assessed with the Stroke Specific Quality of Life Scale. Patients took 2 tablets of prospecta or placebo 2 times a day for 24 weeks. The follow-up period was 4 weeks. The primary endpoint of the study was the proportion of patients with improvement in cognitive function (+1 or more on the MoCA test) after 24 weeks of treatment. The occurrence and type of adverse events (AEs), their severity, relationship to the drug, outcome, changes in vital signs, and the proportion of patients with clinically significant abnormality in laboratory tests were analyzed to assess the safety.

RESULTS

A clinically significant improvement in cognitive function was obtained in 91.9% of patients in the prospecta group vs 82.,1% in the placebo group, (=0.02). There were 57 AEs in 37 (27.4%) Prospecta group patients and 53 AEs in 39 (27.9%) Placebo group participants (=1.00). No AEs were certainly associated with taking the medication. No clinically significant changes in vital signs or abnormal laboratory results were detected during the study.

CONCLUSION

Prospecta is an effective and safe treatment option for patients with moderate cognitive impairment in the early recovery period of ischemic stroke.

摘要

目的

评估Prospecta治疗缺血性中风早期恢复期中度认知障碍的疗效和安全性。

材料与方法

该研究纳入了275例患者(平均年龄64.0±8.1岁),这些患者有单次缺血性中风病史,病程3至6个月,存在中度认知障碍且日常生活活动能力中等,被随机分为两组。在筛查阶段,使用简易精神状态检查表和蒙特利尔认知评估量表评估认知障碍的严重程度;使用巴氏量表评估日常生活活动水平;使用卒中特异性生活质量量表评估生活质量。患者每天服用2片Prospecta或安慰剂,每日2次,共24周。随访期为4周。该研究的主要终点是治疗24周后认知功能改善(蒙特利尔认知评估测试得分提高1分或更多)的患者比例。分析不良事件(AE)的发生情况和类型、严重程度、与药物的关系、结局、生命体征变化以及实验室检查中具有临床意义异常的患者比例,以评估安全性。

结果

Prospecta组91.9%的患者认知功能有临床显著改善,而安慰剂组为82.1%,(P=0.02)。Prospecta组37例(27.4%)患者出现57例不良事件,安慰剂组39例(27.9%)参与者出现53例不良事件,(P=1.00)。没有不良事件肯定与用药有关。研究期间未检测到生命体征的临床显著变化或实验室检查异常结果。

结论

对于缺血性中风早期恢复期的中度认知障碍患者,Prospecta是一种有效且安全的治疗选择。

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