Effect of Early Application of Donepezil on Recovery from Elderly Patients with Post-stroke Cognitive Dysfunction and Serum Hcy and IL-18
Objective To explore the clinical effect of early application of central cholinesterase inhibitor donepezil in elderly patients with post-stroke cognitive dysfunction and the expression of serum homocysteine(Hcy)and interleukin-18(IL-18)in patients.Methods 100 elderly patients with post-stroke cognitive impairment who were hospitalized in Taizhou People's Hospital affiliated with Nanjing Medical University from March 2020 to April 2023 were selected and randomly grouped into early treatment group and delayed treatment group.Done-pezil hydrochloride was added to the early treatment group at the beginning of the disease(within 3-5 days),and donepezil hydrochloride was added to the delayed treatment group at about 3 months of the disease duration.The patients'cognitive function changes were evaluated using the Mini-Mental State Examination(MMSE)combined with the Montreal Cognitive Assessment(MoCA).Fifty elderly patients without cognitive dysfunction after stroke admitted to the hospital during the same period and 50 healthy elderly patients in the outpatient clin-ic during the same period were selected as the control group.Serum Hcy and IL-18 concentrations were mea-sured in all study subjects to analyze the relationship between serum Hcy and IL-18 concentrations and post-stroke cognitive impairment.Results MMSE score and MoCA score were significantly higher in the early treat-ment group compared with the delayed treatment group after 6 months of disease duration(P＜0.05),and serum Hcy and IL-18 levels were higher in patients with post-stroke cognitive impairment than in those without post-stroke cognitive impairment and those with healthy physical examination(P＜0.05);and there was a negative correlation between the post-stroke MMSE score and MoCA score and serum Hcy concentration(P＜0.01).Conclusion Donepezil can effectively improve post-stroke cognitive dysfunction and promote cognitive recov-ery,and early treatment is better than delayed treatment.Serum Hcy and IL-18 levels were higher in elderly pa-tients with post-stroke cognitive dysfunction than in patients without cognitive dysfunction,suggesting that it can be used as one of the biomarkers of cognitive dysfunction after stroke,and that serum Hcy concentration can reflect the severity of post-stroke cognitive dysfunction in patients.
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