摘要
目的探讨法舒地尔联合依达拉奉对颅内破裂动脉瘤术后脑血管痉挛患者血清可溶性细胞间黏附分子-1(SICAM-1)、天冬氨酸蛋白水解酶3(Caspase-3)的影响。方法选择2015年5月~2017年3月收治的蛛网膜下腔出血患者95例,经脑血管造影确诊为动脉瘤,以随机数表法分为观察组50例和对照组45例,对照组使用依达拉奉治疗,观察组在对照组的基础上使用法舒地尔进行治疗。比较两组的术后血管痉挛及迟发脑梗死发生率、治疗前后血清SICAM-1、Caspase-3水平、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)、巴氏(Barthel)指数评分、神经功能缺损(NFI)评分、大脑中动脉(MCA)平均血流速度及不良反应发生情况。结果观察组后血管痉挛及迟发脑梗死发生率均显著低于对照组(P<0.05)。治疗前,两组患者血清SICAM-1、Caspase-3水平无显著差异(P>0.05);治疗后,两组各血清SICAM-1、Caspase-3水平较治疗前均显著下降(P<0.05),且观察组血清SICAM-1、Caspase-3水平均明显低于对照组(P<0.05)。治疗前,两组患者MCA平均血流速度无显著差异(P>0.05);治疗后,两组MCA平均血流速度较治疗前均显著升高(P<0.05),且观察组MCA平均血流速度均明显高于对照组(P<0.05)。治疗前,两组患者GCS评分、Barthel指数评分及NFI评分无显著差异(P>0.05);治疗后,两组GCS评分、Barthel指数评分较治疗前均显著升高,NFI评分显著降低(P<0.05),且观察组GCS评分、Brthel指数评分均明显高于对照组,NFI评分显著低于对照组(P<0.05)。观察组不良反应总发生率为12.00%,显著低于对照组的33.33%(P<0.05)。结论在颅内破裂动脉瘤术后脑血管痉挛患者中使用法舒地尔联合依达拉奉效果显著,可有效改善患者的血清血清SICAM-1、Caspase-3水平,值得推广与运用。
Objective To study curative efficacy of Fashudil joined edalavin in treatment of cerebral vasospasm after intracranial aneurysm ruptureand its effectson serum Soluble intercellular adhesion molecule-1(sicam-1), Aspartic acid proteolytic enzyme 3(caspase-3). Methods 95 patients with subarachnoid hemorrhage admitted from May 2015 to March 2017 were selected and divided into the observation group(n=50) and the control group(n=45). The control group was treated with idaravone and the observation group was treated with fasudil on the basis of the control group. The incidence of postoperative vasospasm and delayed cerebral infarction, serum SICAM 1, Caspase 3 level, Glasgow Coma Scale(Glasgow Coma Scale, GCS), pap(Barthel index score, nerve function defect(NFI) score, middle cerebral artery(MCA) average blood flow velocity and adverse reactions occur were observed. Results The incidence of vasospasm and delayed cerebral infarction in the observation group was significantly lower than that in the control group(P< 0.05). Before treatment, there was no significant difference in serum sicam-1, caspase-3 levels between the two groups(P> 0.05). After treatment, serum sicam-1, caspase-3 levels of the two groups significantly decreased compared with those before treatment(P< 0.05), and serum sicam-1, caspase-3 levels of the observation group were significantly lower than those of the control group(P< 0.05). Before treatment, there was no significant difference in MCA mean blood flow velocity between the two groups(P> 0.05). After treatment, the average MCA blood flow velocity of both groups increased significantly compared with that before treatment(P< 0.05), and the average MCA blood flow velocity of the observation group was significantly higher than that of the control group(P< 0.05). Before treatment, there was no significant difference in GCS score, Barthel index score and NFI score between the two groups(P> 0.05). GCS score after treatment, two groups, the Barthel index score before treatment were significantly elevated, NFI score decreased significantly(P< 0.05), GCS score, Brthel index score and observation group were significantly higher than the control group, NFI score was significantly lower than control group(P< 0.05);The total incidence of adverse reactions in the observation group was 12.00%, significantly lower than the control group’s 33.33%(P< 0.05). conclusion To use in patients with cerebral vasospasm after ruptured intracranial aneurysm shu to adr mentioned joint effect is remarkable, which can effectively improve the patient’s serum SICAM 1, Caspase 3,level, is worth popularization and application.
作者
李捷
龙霄翱
梁远生
李丽球
LI Jie;LONG Xiaoao;LIANG Yuansheng;LI Liqiu(Department of Neurosurgery, The Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong,China)
出处
《西部医学》
2019年第6期931-934,939,共5页
Medical Journal of West China
基金
广东省自然科学基金(S2011010003830)
湛江市科技计划项目(2016B01159)
