Objective To compare effects of butyphthalide and piracetam on malondialdehyde ,superox-ide dismutase,peroxide lipid in patients with vascular dementia .Methods Total of 68 patients with vascular dementia in Heze Mudan People′s Hospital from May 2014 to Apr.2015 were included in the study,accord-ing to the draw method they were divided into an observation group and a control group ,34 cases in each group.The observation group was treated with butyphthalide soft capsule,2 pieces/time,3 times/d;the con-trol group was treated with piracetam,2 pieces/time,3 times/d.They were compared with serum malondial-dehyde,serum superoxide dismutase ( SOD) activity level,lipid peroxide ( LPO) ,degree of fibrinogen,eryth-rocyte sedimentation rate,whole blood low shear viscosity,whole blood viscosity,high shear blood rheology indexes,clinical dementia scale (CDR),daily life ability scale,simple mental state (MMSE) before and after 2 months of treatment,and the clinical efficacy and adverse reactions of two groups of patients were observed.Results After treatment,the malondialdehyde,LPO level of the observation group were lower than the control group[(3.02 ±0.47) mmol/L vs (4.53 ±0.79) mmol/L,(4.24 ±0.37) μmol/L vs (6.32 ± 0.58) μmol/L],SOD was significantly higher than control group[(107.88 ±14.32) U/L vs (95.32 ± 11.32) U/L](P<0.01).The fibrinogen,erythrocyte sedimentation rate,whole blood low shear viscosity, whole blood viscosity,high shear blood rheological index of the observation group were lower than the control group [(3.21 ±0.14) g/L vs (3.96 ±0.32) g/L,(11.35 ±1.34) mm/1 h vs (19.03 ±2.43) mm/1 h, (8.98 ±0.53) mPa· s vs (10.76 ±0.93) mPa· s,(4.21 ±0.68) mPa· s vs (5.33 ±0.92) mPa· s (P<0.01)].CDR score of observation group was lower than the control group[(0.86 ±0.14) scores vs (1.57 ±0.27) scores],ADL and MMSE score of the observation group were higher than the control group [(86.35 ±12.54) scores vs (47.56 ±5.78) scores,(25.7 ±4.9) scores vs (18.0 ±2.5) scores,P <0.01].The total effective rate of the observation group was significantly higher than the control group [85.29%(29/34) vs 58.82% (20/34),P<0.05].Adverse reaction rate of the observation group had no significant difference compared with the control group [ 20.59%( 7/34 ) vs 17.65%( 6/34 ) , P >0.05 ] . Conclusion Butyphthalide can significantly improve the serum malondialdehyde , serum superoxide dis-mutase,and the indexes of blood rheology of patients with vascular dementia ,and is helpful for the improve-ment of the dementia symptoms,mental condition,thus is a safe and effective treatment.%目的：比较丁苯酞和吡拉西坦对血管性痴呆患者血清丙二醛、血清超氧化物歧化酶、过氧化脂质的影响。方法选取2014年5月至2015年4月菏泽市牡丹人民医院收治的血管性痴呆患者68例，按照抽签法分为观察组和对照组，各34例。观察组患者口服丁苯酞软胶囊，2粒／次，3次／d；对照组口服吡拉西坦片，2片／次，3次／d。比较两组患者治疗前和治疗后2个月血清丙二醛、超氧化物歧化酶（ SOD）活性水平、过氧化脂质（ LPO）、纤维蛋白原、红细胞沉降率、全血黏度低切、全血黏度高切血液流变学指标、临床痴呆程度量表（CDR）、日常生活能力量表、简易精神状态量表（MMSE）变化，观察两组患者的临床疗效和不良反应。结果治疗后，观察组患者的丙二醛、LPO水平低于对照组[（3.02±0.47） mmol／L比（4.53±0.79） mmol／L、（4.24±0.37）μmol／L比（6.32±0.58）μmol／L]， SOD水平显著高于对照组[（107.88±14.32） U／L 比（95.32±11.32） U／L]，差异有统计学意义（ P＜0.01）。观察组患者的纤维蛋白原、红细胞沉降率、全血黏度低切、全血黏度高切血液流变学指标低于对照组[（3.21±0.14） g／L 比（3.96±0.32） g／L、（11.35±1.34） mm／1 h 比（19.03±2.43） mm／1 h、（8.98±0.53） mPa· s比（10.76±0.93） mPa· s、（4.21±0.68） mPa· s比（5.33±0.92） mPa· s，P＜0.01]。观察组患者的 CDR 评分显著低于对照组（0.86±0.14）分比（1.57±0.27）分，ADL、MMSE评分显著高于对照组[（86.35±12.54）分比（47.56±5.78）分、（25.7±4.9）分比（18.0±2.5）分]，差异有统计学意义（P＜0.01）。观察组患者总有效率显著高于对照组[85.29％（29／34）比58.82％（20／34），P＜0.05]。观察组不良反应发生率与对照组比较差异无统计学意义[20.59％（7／34）比17.65％（6／34），P＞0.05]。结论丁苯酞能明显改善血管性痴呆患者血清丙二醛、血清超氧化物歧化酶活性及血液流变学等指标，有利于患者痴呆症状、精神状况的改善，属于安全有效的治疗方式。
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