目的 研究美金剛聯(lián)合茴拉西坦對血管性癡呆的療效及對血清雌二醇（E2）、內(nèi)皮生長因子（VEGF）水平的影響。方法 選擇2016年9月-2018年07月在許昌市立醫(yī)院進行診治的350例血管性癡呆患者，隨機分為兩組。對照組服用茴拉西坦，每次0.2 g，每天3次；觀察組聯(lián)合服用美金剛5 mg/d，每周將給藥劑量遞增5 mg，到第4周的20 mg/d時維持給藥劑量。兩組均治療6個月。比較兩組的認知功能MMSE評分、病理行為評分和血清E2、VEGF水平。結(jié)果 觀察組的有效率（85.14%）明顯高于對照組（64.57%），差異有統(tǒng)計學(xué)意義（P<0.05）。兩組治療后的認知功能MMSE評分均明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且觀察組明顯高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。兩組治療后的幻覺、偏執(zhí)妄想、行為紊亂、晝夜節(jié)律紊亂、攻擊行為、焦慮恐懼以及情感障礙評分值均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05），且觀察組明顯低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。兩組治療后的血清E2、VEGF水平均明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且觀察組明顯高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 美金剛聯(lián)合茴拉西坦對血管性癡呆患者具有確切的療效，其作用機制可能與提高血清E2、VEGF水平相關(guān)。

Objective To investigate the clinical effect of aniracetam combined with memantine on serum E2 and VEGF levels in patients with vascular dementia. Methods Selected 350 cases of patients with vascular dementia who were treated in our hospital from September 2016 to July 2018, divided into two groups randomly. The control group was given Ra Laci Staw and the observation group was treated with memantine. Cognitive function MMSE score, pathological behavior score, serum E2 and VEGF levels were compared between the two groups. Results The effective rate of the observation group was significantly higher than control group (P<0.05). The cognitive function MMSE scores of the two groups increased significantly after treatment (P<0.05), and the observation group was more significant (P<0.05). The scores of hallucinations, paranoia, behavior disorder, circadian rhythm disorder, attack behavior, anxiety and fear, and affective disorder scores in the two groups were significantly decreased (P<0.05), and the observation group was more obvious (P<0.05). The serum E2 and VEGF levels of the two groups increased significantly (P<0.05), and the observation group was more significant (P<0.05). Conclusion Aniracetam combined with memantine has definite curative effect on vascular dementia patients, and its mechanism may be related to the elevation of serum E2 and VEGF levels.