文章摘要
黎春镛 ，罗高权 ，刘榴 ，陈欢 ，刘雷媛 ，武肖娜 ，韩立新.多奈哌齐对急性缺血性脑卒中运动性失语患者的言语功能的影响[J].神经损伤功能重建,2020,15(2):78-80
多奈哌齐对急性缺血性脑卒中运动性失语患者的言语功能的影响
Effect of Donepezil on Language Function in Patients with Motor Aphasia after AcuteIschemic Stroke
  
DOI：
中文关键词: 多奈哌齐  缺血性脑卒中  运动性失语  神经可塑性  布洛卡脑区  功能磁共振
英文关键词: donepezil  ischemic stroke  motor aphasia  neuroplasticity  Broca’s area  functional magnetic resonance imaging
基金项目:国家自然科学基金 （No. 81471172）
作者单位
黎春镛1a ，罗高权1a ，刘榴1a ，陈欢2 ，刘雷媛1a ，武肖娜1a ，韩立新1b 1. 中国人民解放军 南部战区总医院 a. 脑血管科，b.核磁 共振室 2. 广州市从化区街 口街社区卫生服务 中心综合一科 
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中文摘要:
      目的：探讨多奈哌齐对急性缺血性脑卒中后运动性失语患者语言功能的影响。方法：急性缺血性脑 卒中运动性失语患者30例随机分为多奈哌齐组和对照组，各15例。2组均给予常规抗血小板聚集等基础治 疗，多奈哌齐组加用盐酸多奈哌齐片治疗，同时给予康复及语言治疗，疗程均为2周。所有患者分别于治疗 前、后，检查血常规、肝肾功能、凝血常规，并进行语言任务态的功能磁共振扫描、美国国立卫生院脑卒中量 表（NIHSS）评分及失语指数（AQ）评分。结果：治疗前，治疗后，2组的AQ及NHISS评分均较治疗前改善 （均P＜0.01）；且多奈哌齐组改善程度较对照组明显（均P＜0.01）。治疗后，多奈哌齐组诱导出的激活增强 主要位于左侧额中回后部Broca区（BA44/45）（P＜0.01，FDR，Ke≥10）；多奈哌齐诱导出的Broca区激活增 强与AQ改善成正相关（P＜0.05）。结论：多奈哌齐能促进急性缺血性脑卒中运动性失语患者语言功能区的 激活，促进脑功能的重塑，有利于语言损伤的恢复。
英文摘要:
      To investigate the effect of donepezil on the language function of patients with motor aphasia after acute ischemic stroke. Methods: Thirty patients with motor aphasia and acute ischemic stroke were randomly divided into the donepezil group and the control group with 15 patients per group. Both groups were given conventional anti-platelet therapy and basic treatment, and the donepezil group was additionally given donepezil hydrochloride tablets. Both groups were also given concurrent rehabilitation care and speech therapy. The treatment duration was 2 weeks. All patients underwent routine blood examination, liver and kidney function assessment, and routine coagulation testing. Language fMRI, National Institute of Health Stroke Scale (NIHSS) scoring, and aphasia quotient (AQ) scoring were performed. Results: After treatment, AQ and NIHSS scores of both groups improved compared with those before treatment (all P<0.01), and the improvement in the donepezil group was more significant than that in the control group (all P<0.01). In the donepezil group after treatment, there was enhanced activation in the Broca’s area (BA44/45) of the left middle frontal gyrus (P<0.01, FDR, Ke≥10). The enhanced activation of the Broca's area (BA44/45) produced by donepezil was positively correlated with AQ improvement (P<0.05). Conclusion: Donepezil can promote the activation of the language function area and boost language recovery in acute ischemic stroke patients with motor aphasia; it enhances reestablishment of brain function and is helpful in the recovery from aphasia.
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