Objective To compare the efficacy of cilostazol and aspirin in the treatment of vascular dementia with white matter lesions.Methods 50 patients with vascular dementia with white matter lesions were randomly divided into control group (aspirin and nimodipine group)and observation group (cilostazol and nimodipine group). The control group was orally given aspirin enteric -coated tablets and nimodipine tablets,the observation group was treated with cilostazol tablets and nimodipine tablets.Then,the patients were followed up,compared the cognitive function and adverse events of the two groups after treatment 6 months and 1 2 months.Results 6 months and 1 2 months after treatment,MMSE score and MoCA score of the control group were significantly improved[the MMSE score and MoCA score before treatment were (20.1 2 ±4.25)points,(1 4.25 ±4.25)points,6 months after treatment were (21 .22 ±4.68)points,(1 6.45 ±3.25)points,1 2 months after treatment were (22.38 ±5.64),(1 6.95 ± 4.68);6 months after treatment,t =0.87,2.06;1 2 months after treatment,t =1 .96,2.1 4,all P <0.05].6 months and 1 2 months after treatment,MMSE score and MoCA score of the observation group were significantly improved than before treatment [before treatment the MMSE score and MoCA score were (1 9.85 ±5.1 4)points,(1 3.98 ± 6.28)points,6 months after treatment were (23.76 ±4.1 5)points,(1 8.75 ±4.28)points,1 2 months after treatment were (25.26 ±3.72)points,(23.95 ±5.43 )points,6 months after treatment t =2.96,3.1 4;1 2 months after treatment,t =4.26,6.00,all P <0.05].6,1 2 months after treatment,the MMSE score between the two groups had significant difference (t =2.03,2.1 3,all P <0.05),MoCA score between two groups had significant difference(t =2.1 4,4.88,all P <0.05).The incidence rates of cerebral hemorrhage in the observation group and control group were 0.00%,1 2.00%,the difference was significant (χ2 =3.1 9,P <0.05).Conclusion Cilostazol and nimodipine in the treatment of vascular dementia with white matter lesions,can significantly improve cognitive function of patients, and has less cerebral hemorrhage,significantly clinical effect,good security.

Objective:To investigate the correlation between cognitive impairment and blood glucose, serum neuron specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) levels after ischemic small-artery stroke.Methods:A total of 160 patients with ischemic small-artery stroke who received treatment in Jincheng People's Hospital from January 2018 to December 2019 were included in this study. They were divided into an observation group (with cognitive impairment, n = 68) and a control group (without cognitive impairment, n = 92) according to whether they had cognitive impairment. General data, blood glucose, NSE and BDNF levels were compared between the two groups. Multivariate logistic regression analysis was used to analyze the correlation between cognitive impairment and each factor after ischemic small-artery stroke. Results:There were no significant differences in gender, age, course of disease, body mass index, history of hypertension, hyperlipidemia, history of type 2 diabetes mellitus, history of smoking, and history of drinking between the two groups (all P > 0.05). The National Institute Health of Stroke Scale (NIHSS) score in the observation group was significantly higher than that in the control group [(18.86 ± 4.08) points vs. (14.27 ± 2.66) points, t = 6.664, P < 0.05], and the Mini-Mental State Examination (MMSE) score in the observation group was significantly lower than that in the control group [(21.45 ± 3.03) points vs. (24.28 ± 3.32) points, t = 4.452, P < 0.05]. There were no significant differences in glycosylated hemoglobin, fasting blood glucose, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and total cholesterol levels between the two groups (all P > 0.05). There were significant differences in oxidized low-density lipoprotein (ox-LDL), NSE and BDNF levels between the two groups. The ox-LDL [(44.8 ± 7.6) mmol/L] and NSE [(26.5 ± 9.5) ng/mL] levels in the observation group were significantly higher than those in the control group [(35.9 ± 4.7) mmol/L, (11.6 ± 6.9) ng/mL, t = 7.04, 8.973, both P < 0.05]. BDNF level in the observation group was significantly lower than that in the control group [(5.1 ± 1.8) ng/mL vs. (6.3 ± 2.4) ng/mL, t = 2.828, P < 0.05]. Multivariate logistic regression analysis showed that ox-LDL and NSE levels and NIHSS score were independent risk factors of cognitive impairment after ischemic small-artery stroke (all P < 0.05), and BDNF level and MMSE score were independent protective factors (all P < 0.05). Conclusion:Cognitive impairment was correlated with NIHSS score, MMSE score, ox-LDL, NSE and BDNF levels in patients with ischemic small-artery stroke. ox-LDL and NSE levels as well as NIHSS score were independent risk factors and BDNF level and MMSE score were independent protective factors of ischemic small-artery stroke.

Objective:To explore the correlations between serum levels of brain-derived neurotrophic factor(BDNF),interleukin-18(IL-18)and hypersensitivity C-reactive protein(hs-CRP)in patients with acute cerebral infarction and vascular cognitive impairment(VCI),and to provide some clinical ba-ses for early prevention of VCI.Methods:A total of 160 patients with acute cerebral infarction admitted in Department of Neurology of Jincheng People's Hospital from May 2019 to April 2020 were enrolled in this study and were devided into three groups according to whether or not combined with cognitive impair-ment,including no cognitive impairment group(NCI,57 cases),vascular cognitive impairment no de-mentia group(VCIND,56 cases)and vascular dementia group(VaD,47 cases).The cognitive function of all the patients were evaluated by Montreal cognitive assessment(MoCA).The National Institute of Health stroke scale(NIHSS)was used to assess the degree of neurological deficit(mild-,moderate-,se-vere-neurologic deficit group).The infarct size was calculated by Pullicino's method(small-,middle-,large-infarct group).The levels of serum BDNF and IL-18 were measured by enzyme-linked immunosor-bent assay(ELISA),and serum levels of hs-CRP were measured by immunoturbidimetry during the acute phase(0-7 d),recovery period(15-30 d)and 6 months after cerebral infarction.The effects of varying degrees of neurological deficits and different size of infarction on BDNF,IL-18 and hs-CRP were observed.The levels of serum BDNF,IL-18 and hs-CRP in the patients of the three groups with acute,convalescent and six-month cerebral infarction were compared,and their correlations with VCI were ana-lyzed.Results:Serum BDNF level and MoCA scores in mild-neurologic deficit group and small-infarct group were significantly higher than those in moderate-and severe-deficit group,middle-and large-infarct group,respectively(P＜0.05).Their levels of IL-18 and hs-CRP were significantly lower than those in moderate-and severe-deficit group,middle-and large-infarct group,respectively(P＜0.05).The levels of serum BDNF in NCI group,VCIND group and VaD group during the acute phase,convalescence and 6 months after cerebral infarction were in a significant decline,and the differences during the acute phase and recovery period were statistically significant(P＜0.05).The levels of IL-18 and hs-CRP during the acute phase,recovery period and 6 months after cerebral infarction showed a significant increasing trend with significance(P＜0.05).Correlation analysis revealed that the levels of BDNF was positively correlated with MoCA scores but negatively correlated with the severity of cognitive impairment while the expression levels of IL-18 and hs-CRP were negatively correlated with MoCA scores but positively correlated with the severity of cognitive impairment.Conclusion:Serum BDNF,IL-18 and hs-CRP are involved in the patho-logical process of occurrence and development of VCI in the patients with acute cerebral infarction.BDNF has a protective effect on VCI while IL-18 and hs-CRP cause severe cognitive impairment.The levels of se-rum BDNF、IL-18 and hs-CRP in the patients with acute ischemic cerebral infarction are closely related to the severity of cognitive impairment and can be used as biomarkers of early diagnosis of VCI.