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目的：观察奥拉西坦联合多奈哌齐治疗高龄血管性痴呆（VD ）的临床疗效。方法老年VD患者96例随机均分为两组：B组每天口服多奈哌齐5 mg ，连续6个月；A组加用奥拉西坦4 g ，加入生理盐水250 ml中静脉滴注，每天1次，21 d为1个疗程，每3个月治疗1个疗程。于治疗前和治疗6个月后进行蒙特利尔认知评估量表（MoCA）、简易精神状态量表（MMSE）和日常生活能力量表（ADL ）评分，比较两组疗效。结果两组患者治疗6个月后，M oCA评分和M M SE评分均较治疗前增加（P＜0．05），ADL评分降低（P＜0．05）。治疗6个月后，A组 MoCA和 MMSE评分高于B组，ADL评分低于B组（P＜0．05）。A组有效率为89.58％，高于B组的68.75％（P＜0．05）。两组患者治疗前后的肝肾功能均无明显变化（P＞0．05）。结论奥拉西坦复合多奈哌齐治疗老年VD的疗效优于多奈哌齐单药治疗。“,”Objective To observe the efficacy of combined use of oxiracetam and donepezil in the treatment of elderly vascular dementia (VD ) .Methods Ninety-six elderly VD patients were equally and randomly divided into two groups .The patients in group B were treated with oral donepezil 5 mg daily for 6 months ,and those in group A were given additional oxiracetam 4 g in 250 ml normal saline ,which was infused once a day for 21 days as a therapy course in every 3 months .The efficacy was evaluated with the scores of Montreal cognitive assessment (MoCA ) ,minimental state examination (MMSE) and activities of daily living (ADL) before and in 6 months after treatment . Results Compared to before ,MoCA and MMSE scores were significantly higher and ADL score was lower in 6 months after treatment in both groups(P<0 .05) .After treatment ,the scores of MoCA and MMSE were higher and ADL score was lower in group A than those in group B (P<0 .05) .The overall effectiveness rate was higher in group A than that in group B (89 .58% vs .68 .75% ) (P0 .05 ) .Conclusion The efficacy of combined use of oxiracetam and donepezil in the treatment of elderly VD is better than donepezil alone .