Efficacy of citicoline combined with edaravone in patients with post-stroke vascular cognitive impairment
WANG Huan
WANG Huici
ZHAO Jingyi
WU Tong
Abstract：Objective To explore the efficacy of citicoline combined with edaravone in patients with post-stroke vascular cognitive impairment(VCI)and its effect on serum levels of homocysteine(Hcy)and free triiodothyronine(FT3).Methods A prospective randomized controlled trial was conducted.A total of 122 patients with post-stroke VCI after cerebral infarction,admitted to Xingtai People's Hospital between January 2024 and June 2025,were enrolled and randomly assigned to the citicoline combination group and the edaravone group using a random number table method.The edaravone group(n=61)received edaravone monotherapy,while the citicoline combination group(n=61)received citicoline in combination with edara-vone.The clinical efficacy,cognitive function scores,serum levels of Hcy and FT3,inflammatory factors(C-reactive protein,tu-mor necrosis factor-α,interleukin-6),cerebral hemodynamic indicators(middle cerebral artery systolic flow velocity,mean flow velocity,pulsatility index),and the incidence of adverse reactions were compared between the two groups.Results The total effective rate in the citicoline combination group(88.52%(54/61))was higher than that in the edaravone group(72.13%(44/61))(χ2=5.187,P=0.023).After treatment,the scores of the Montreal Cognitive Assessment and the Mini-Mental State Examination in the citicoline combination group((25.82±1.23),(24.79±2.37)points)were higher than those in the edaravone group((23.94±1.17),(22.51±1.78)points)(t=8.649,6.008,both P<0.05).After treatment,the Hcy level in the citicoline combination group((15.39±2.52)μmol/L)was lower than that in the edaravone group((18.94±3.28)μmol/L),and the FT3 level((6.20±0.65)pmol/L)was higher than that in the edaravone group((5.21±0.42)pmol/L)(t=6.703,9.991,both P<0.05).After treatment,the levels of C-reactive protein,tumor necrosis factor α,and interleukin-6 in the citicoline combination group((6.32±1.04)mg/L,(32.56±4.57)pg/mL,(26.42±3.15)pg/mL)were lower than those in the edaravone group((8.19±1.67)mg/L,(40.19±5.58)pg/mL,(31.25±3.66)pg/mL)(t=7.424,8.262,7.812,all P<0.05).After treatment,the levels of systolic flow velocity,mean flow veloc-ity,and pulsatility index in the citicoline combination group((93.19±5.68)cm/s,(65.26±4.22)cm/s,(0.72±0.08))were superior to those in the edaravone group((89.44±5.50)cm/s,(61.83±4.77)cm/s,(0.79±0.10))(t=3.704,4.206,4.269,all P<0.05).The incidence of adverse reactions did not differ significantly between the citicoline combination group(13.11%(8/61))and the eda-ravone group(11.48%(7/61))(χ2=0.076,P=0.783).Conclusion Citicoline combined with edaravone demonstrates confirmed efficacy in treating patients with post-stroke VCI.It improves patients'cognitive function,cerebral hemodynamics,and inflam-matory responses,regulates serum Hcy and FT3 levels,and exhibits a favorable safety profile.
Keywords：cerebral infarctionvascular cognitive impairmentciticolineedaravonehomocysteinefree triiodothyronine
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 207-211 )