依达拉奉注射液治疗颅内动脉瘤夹闭术后早期脑缺血患者的临床研究

发布时间：2018-04-21 14:43

本文选题：依达拉奉注射液 + 颅内动脉瘤夹闭术　；参考：《中国临床药理学杂志》2017年03期

【摘要】：目的观察依达拉奉注射液对颅内动脉瘤夹闭术后早期脑缺血(ECI)患者的影响。方法 78例颅内动脉瘤夹闭术后早期脑缺血患者随机分为对照组39例和试验组39例。2组均给予高血容量、高灌注压、高血液稀释度等常规治疗。对照组静脉滴注等量的0.9%Na Cl;试验组在此基础上静脉滴注依达拉奉注射液30 g,加入0.9%Na Cl 100 m L中,30 min内滴注完毕,每日2次。2组均治疗14 d。比较2组患者的神经功能恢复情况及预后情况。结果治疗后,试验组和对照组的神经功能缺损程度评分(NFD)分别为(7.36±5.42),(10.71±4.39)分;Barthel评分分别为(49.20±13.32),(37.58±11.46)分,差异均有统计学意义(P0.05)。治疗后,试验组和对照组的大脑中动脉血流速度分别为(95.38±19.60),(118.25±17.94)cm·s~(- 1);脑血管痉挛(CVS)发生率分别为12.82%(5/39例),33.33%(13/39例),差异均有统计学意义(P0.05)。试验组格拉斯哥预后评分(GOS)5分的比例为79.49%(31/39例),对照组为58.97%(23/39例),差异有统计学意义(P0.05)。治疗后,试验组血清超氧化物歧化酶(SOD)、一氧化氮(NO)和丙二醛(MDA)分别为(93.26±13.71)U·m L~(-1),(5.29±0.53)nmol·m L~(-1),(63.29±10.58)mol·L~(-1);脑脊液SOD、NO、MDA分别为(61.34±4.26)U·m L~(-1),(4.40±0.25)nmol·m L~(-1),(1.83±0.37)mol·L~(-1)。对照组血清SOD、NO、MDA分别为(80.20±11.59)U·m L~(-1),(6.74±0.32)nmol·m L~(-1),(50.91±9.37)mol·L~(-1),脑脊液SOD、NO、MDA分别为(54.29±6.64)U·m L~(-1),(5.12±0.83)nmol·m L~(-1),(1.50±0.24)mol·L~(-1)。试验组与对照组比较,差异均有统计学意义(P0.05)。2组治疗期间均未见明显药物不良反应发生。结论依达拉奉注射液对血清及脑脊液氧自由基的清除作用,能够显著降低颅内动脉瘤夹闭术后早期脑缺血患者CVS发生率。
[Abstract]:Objective to observe the effect of Edaravone injection on early cerebral ischemia (ECI) after intracranial aneurysm clipping. Methods Seventy-eight patients with early cerebral ischemia after intracranial aneurysm clipping were randomly divided into control group (39 cases) and experimental group (39 cases). The control group was given the same amount of 0.9%Na Cl, and the experimental group was treated with Edaravone injection for 14 days after 30 min of Edaravone injection was added to 0.9%Na Cl 100 mL. The recovery of nerve function and prognosis were compared between the two groups. Results after treatment, the NFDs of the experimental group and the control group were 7.36 卤5.42 and 10.71 卤4.39, respectively. The Barthel score was 49.20 卤13.32 and 37.58 卤11.46, respectively. The difference was statistically significant (P 0.05). After treatment, the blood flow velocity of the middle cerebral artery in the experimental group and the control group were 95.38 卤19.60 卤118.25 卤17.94)cm, respectively, and the incidence of cerebral vasospasm was 12.82% in 539 cases (P 0.05). The proportion of Glasgow prognostic score (GOS) 5 in the trial group was 79.499.49 / 39, and that in the control group was 58.97 / 23 / 39. The difference was statistically significant (P 0.05). After treatment, the serum levels of superoxide dismutase (SOD), nitric oxide (no) and malondialdehyde (MDA) in the experimental group were 93.26 卤13.71 U / mL, 5.29 卤0.53)nmol / mL, 63.29 卤10.58)mol / L, respectively, and those in cerebrospinal fluid were 61.34 卤4.26 U / mL and 1.83 卤1.83 卤0.37)mol / L, respectively. In the control group, the levels of MDA in serum of the control group were 80.20 卤11.59U / mL, 6.74 卤0.32)nmol / mL / L, 50.91 卤9.37)mol / L, respectively, and 54.29 卤6.64U / mL / L and 5.12 卤0.83)nmol / mL / L, respectively, respectively. Compared with the control group, there were no significant adverse drug reactions during the treatment in the test group and the control group. Conclusion the scavenging effect of Edaravone injection on oxygen free radicals in serum and cerebrospinal fluid can significantly reduce the incidence of CVS in early cerebral ischemia patients after intracranial aneurysm clipping.
【作者单位】：赣州市人民医院神经外科;
【基金】：江西省卫生计生委科技计划基金资助项目(20157175)
【分类号】：R651.1

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