目的 對比分析吡拉西坦與奧拉西坦對老年腦出血后認(rèn)知功能障礙的治療效果。方法 選擇2012年1月~2015年12月在銅川市人民醫(yī)院進(jìn)行診治的老年腦出血患者82例，按照治療藥物的不同分為吡拉西坦組和奧拉西坦組，分別采用吡拉西坦和奧拉西坦進(jìn)行治療。比較兩組治療前后的蒙特利爾認(rèn)知評估量表（MoCA）、簡易精神狀態(tài)檢查量表（MMSE）和日常生活能力量表（ADL）評分，以及治療1、3、6個(gè)月后的神經(jīng)元特異烯醇化酶水平和認(rèn)知功能改善情況。結(jié)果 治療后，兩組的MoCA、MMSE、ADL評分均明顯改善（P<0.05），且奧拉西坦組明顯優(yōu)于吡拉西坦組（P<0.05）；與治療1個(gè)月相比，兩組治療6個(gè)月的MoCA、MMSE、ADL顯效率及總有效率均明顯升高（P<0.05），且奧拉西坦組明顯優(yōu)于吡拉西坦組（P<0.05）；兩組治療1、3、6個(gè)月后的神經(jīng)元特異烯醇化酶水平均較治療前明顯降低（P<0.05），且奧拉西坦組在治療3、6個(gè)月的神經(jīng)元特異烯醇化酶水平明顯低于吡拉西坦組（P<0.05）；兩組的不良反應(yīng)發(fā)生率相比無明顯差異。結(jié)論 奧拉西坦改善老年腦出血后認(rèn)知功能障礙的效果較吡拉西坦更佳，且療效隨著用藥時(shí)間的延長而增加，并能降低神經(jīng)元特異烯醇化酶水平，具有較高的臨床應(yīng)用價(jià)值。

Objective To compare the effects of piracetam and oxiracetam on elderly cognitive dysfunction after cerebral hemorrhage.Methods Elderly patients (82 cases) with cerebral hemorrhage treated in Tongchuan People's Hospital from January 2012 to December 2015 were selected and divided into two groups according to the different treatment drugs. Two groups were treated by oxiracetam and piracetam respectively. The Montreal cognitive assessment scale (MoCA), simple mental state examination (MMSE), and daily life ability scale (ADL) score of the two groups before and after treatment were compared. The neuron-specific enolase levels and cognitive function after treatment of 1, 3, and 6 months were also compared.Results After treatment, MoCA, MMSE, and ADL scores of two groups were significantly improved (P<0.05), and oxiracetam group were significantly better than piracetam group (P<0.05). After treatment 6 months, MoCA, MMSE, ADL effective and total effective rate of the two groups were significantly higher (P<0.05), and oxiracetam group were significantly better than those of piracetam group (P<0.05). After treatment for 1, 3, and 6 months, the neuron-specific enolase levels were significantly lower than those before treatment (P<0.05), and in the treatment of 3 and 6 months, oxiracetam group were significantly lower than piracetam group (P<0.05). The incidence of adverse reactions had no significant difference.Conclusion Oxiracetam can improve the elderly cognitive dysfunction after cerebral hemorrhage, the curative effect was increased with the prolonging of the time, and can reduce the neuron-specific enolase levels, which has high clinical value.