法舒地尔联合尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床研究

发布时间：2019-04-10 17:54

【摘要】：目的观察法舒地尔联合尼莫地平对蛛网膜下腔出血后脑血管痉挛患者近期及远期疗效。方法 87例蛛网膜下腔出血后脑血管痉挛患者随机分为对照组43例与试验组44例。2组均给予常规治疗,对照组持续泵入法舒地尔注射液60 mg,每日1次;试验组在对照组基础上泵注5%尼莫地平注射液1~2 mg·h~(-1),每日1次,2组均连续用药2周。比较2组患者血清核因子-κB(NF-κB)、基质金属蛋白酶-9(MMP-9)水平,评价治疗后的临床疗效。随访3个月,用格拉斯哥预后量表评价患者的远期疗效。结果试验组的近期总有效率为95.45%,远期总有效率为86.36%,显著高于对照组的81.40%与67.44%(P0.05)。治疗后试验组血清NF-κB及MMP-9水平为(0.12±0.02),(137.67±17.65)mmol·L~(-1),均显著低于对照组的(0.23±0.03),(167.65±23.38)mmol·L~(-1)(P0.05)。对照组不良反应发生率为18.60%,试验组为6.82%,差异无统计学意义(P0.05)。结论法舒地尔联合尼莫地平对蛛网膜下腔出血后脑血管痉挛患者近期及远期疗效较好,且能降低血清NF-κB和MMP-9水平。
[Abstract]:Objective to observe the short-term and long-term effects of fasudil combined with nimodipine on cerebral vasospasm after subarachnoid hemorrhage. Methods 87 patients with cerebral vasospasm after subarachnoid hemorrhage were randomly divided into control group (n = 43) and trial group (n = 44). On the basis of the control group, 5% nimodipine injection was infused with 5% nimodipine 1 mg 路h ~ (- 1) once a day for 2 weeks. The serum levels of NF- 魏 B and MMP-9 were compared between the two groups and the clinical efficacy was evaluated. Follow-up for 3 months, Glasgow prognosis scale was used to evaluate the long-term outcome of the patients. Results the short-term and long-term effective rates of the experimental group were 95.45% and 86.36% respectively, which were significantly higher than that of the control group (81.40% and 67.44%, P0.05). After treatment, the levels of serum NF- 魏 B and MMP-9 in the experimental group were (0.12 卤0.02), (137.67 卤17.65) mmol 路L ~ (- 1), which were significantly lower than those in the control group (0.23 卤0.003). (167.65 卤23.38) mmol 路L ~ (- 1) (P0.05). The incidence of adverse reactions was 18.60% in the control group and 6.82% in the test group. There was no significant difference between the two groups (P0.05). Conclusion fasudil combined with nimodipine is effective in the treatment of cerebral vasospasm after subarachnoid hemorrhage, and can reduce the levels of serum NF- kappa B and MMP-9 in patients with cerebral vasospasm after subarachnoid hemorrhage.
【作者单位】：郑州大学第二附属医院神经外科;
【基金】：河南省科技厅科技攻关基金资助项目(112102310173)
【分类号】：R743.35

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