目的 比較奧拉西坦和吡拉西坦治療老年腦出血后認(rèn)知功能障礙的臨床療效和安全性。方法 上海中冶職工醫(yī)院2012年2月—2013年12月收治的老年腦出血患者104例，隨機分為對照組和治療組，每組各52例。對照組口服吡拉西坦片，4片/次，3次/d。治療組口服奧拉西坦膠囊，2粒/次，3次/d。兩組均持續(xù)治療6個月。分別于治療前后采用蒙特利爾認(rèn)知評估（MoCA）量表、簡易智能精神狀態(tài)檢查（MMSE）量表和日常生活活動（ADL）量表進(jìn)行認(rèn)知功能評定。結(jié)果 治療后，兩組MoCA、MMSE量表的項目評分均較治療前顯著提高，同組治療前后差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組MoCA量表中執(zhí)行功能、計算評分高于對照組；治療組MMSE量表中即刻回憶力、注意計算力、語言能力、總分均高于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。兩組不良反應(yīng)發(fā)生率比較差異無統(tǒng)計學(xué)意義。結(jié)論 奧拉西坦較吡拉西坦可更好的改善老年腦出血后患者的認(rèn)知功能障礙，且不良反應(yīng)較少，具有良好的臨床療效和安全性。

Objective To compare the clinical efficacy and safety between oxiracetam and piracetam in the treatment of elderly cognitive dysfunction after cerebral hemorrhage. Methods Elderly cerebral hemorrhage patients (104 cases) who came to Zhongye Worker Hospital in Shanghai from February 2012 to December 2013 were randomly divided into control and treatment groups, and there were 52 cases in each group. The patients in the control group were po administered with Piracetam Tablets, 4 tablets/time, three times daily. The patients in the treatment group were po administered with Oxiracetam Capsules, 2 capsules/time, three times daily. The patients in the two groups were treated for 6 months. Cognitive function was assessed by Montreal cognitive assessment (MoCA) scale, minimum mental state examination (MMSE) activities and daily living (ADL) before and after the treatment. Results After the treatment, project scores of MoCA and MMSE scales were significantly improved, and the difference was statistically significant before and after the treatment in the same group (P < 0.05). After the treatment, the executive function and calculation scores of MoCA scale in the treatment group were higher than those in the control group, while immediate recall force, computing power, language ability, and total scores of MMSE scale were higher than those in the control group, and there were differences between the two groups (P < 0.05). There was no difference on the incidence of adverse drug reactions (ADR) between the two groups. Conclusion Compared with piracetam, oxiracetam can effectively improve the cognitive dysfunction of elderly patients after cerebral hemorrhage, and have good clinical efficacy and safety with less ADR.

軍隊“十二五”軍隊醫(yī)療機構(gòu)制劑標(biāo)準(zhǔn)提高專項課題（13ZJZ17-2）