| 沈 杰,车雄宇,高亚宏,胡 鹏,胡卫武.前列地尔联合尼莫地平对动脉瘤性蛛网膜下腔出血后脑血管痉挛患者血管内皮功能及炎症因子水平的影响[J].,2019,19(5):859-863 |
| 前列地尔联合尼莫地平对动脉瘤性蛛网膜下腔出血后脑血管痉挛患者血管内皮功能及炎症因子水平的影响 |
| Effects of Alprostadil and Nimodipine on Vascular Endothelial Function and Inflammatory Factors in Patients with Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage |
| 投稿时间：2018-11-06 修订日期：2018-11-30 |
| DOI：10.13241/j.cnki.pmb.2019.05.014 |
| 中文关键词: 前列地尔 尼莫地平 动脉瘤性 蛛网膜下腔出血 脑血管痉挛 |
| 英文关键词: Alprostadil Nimodipine Aneurysmal Subarachnoid hemorrhage Cerebral vasospasm |
| 基金项目:湖南省科技计划项目（2014KS00219） |
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| 中文摘要: |
| 摘要 目的：探讨前列地尔联合尼莫地平对动脉瘤性蛛网膜下腔出血（aSAH）后脑血管痉挛（CVS）患者血管内皮功能及炎症因子水平的影响。方法：选取76例于2015年3月~2017年8月间在中南大学湘雅医院住院治疗的aSAH后CVS患者为研究对象，按随机数字表法将患者分为对照组（n=38）及观察组（n=38）。对照组在常规治疗基础上采用尼莫地平治疗，观察组在对照组基础上加用前列地尔治疗。比较治疗前后两组患者的大脑前、后、中动脉平均血流速度，观察并比较两组患者血浆降钙素基因相关肽（CGRP）、内皮素-1（ET-1）水平以及血清血管内皮生长因子（VEGF）、白细胞介素-8（IL-8）、超敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）水平的变化情况，评价两组疗效并观察治疗过程中的不良反应发生情况。结果：与对照组比较，治疗后观察组大脑前、后、中动脉血流速度均明显降低（P<0.05）。与治疗前比较，治疗后两组患者CGRP水平明显升高，与对照组比较，治疗后观察组CGRP水平明显升高（P<0.05），而治疗后两组患者ET-1、VEGF水平明显下降，且观察组低于对照组（P<0.05）。与治疗前比较，治疗后两组患者IL-8、hs-CRP、TNF-α水平均明显下降，且与对照组比较，观察组IL-8、hs-CRP、TNF-α水平均降低（P<0.05）。观察组患者治疗的总有效率为92.11%，明显高于对照组的73.68%（P<0.05）。观察组总不良反应发生率与对照组比较差异无统计学意义（P>0.05）。结论：前列地尔与尼莫地平联合使用治疗aSAH后CVS能明显改善患者的血管内皮功能，降低炎症因子水平，且未增加用药的不良反应，治疗效果较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of alprostadil and nimodipine on vascular endothelial function and inflammatory factors in patients with aneurysmal subarachnoid hemorrhage (aSAH) after cerebral vasospasm (CVS). Methods: 76 cases of aSAH after CVS patients who were hospitalized in Xiangya Hospital of Central South University from March 2015 to August 2017 were selected as the research subjects, the patients were divided into the control group(n=38) and the observation group(n=38) according to the random number table method. The control group was treated with nimodipine on the basis of routine treatment, the observation group was treated with alprostadil on the basis of the control group. The average velocity of blood flow in the anterior, posterior and middle cerebral arteries of the two groups before and after treatment were compared. The changes of plasma calcitonin gene related peptide (CGRP),endothelin-1 (ET-1) and the level of serum vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8), high sensitive C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) were observed and compared, the efficacy of two groups were evaluated and the occurrence of adverse reactions in the treatment were observed. Results: Compared with the control group, the blood flow velocity of anterior cere- bral artery, posterior cerebral artery and middle cerebral artery in the observation group after treatment were decreased significantly(P<0.05). Compared with those before treatment, the level of CGRP in the two groups after treatment was significantly increased, compared with the control group, the level of CGRP in the observation group after treatment was significantly increased(P<0.05). After treatment, the levels of ET-1 and VEGF in the two groups were significantly decreased, and the observation group was lower than that in the control group (P<0.05). Compared with those before treatment, the levels of IL-8, hs-CRP and TNF-α in the two groups after treatment were sig- nificantly decreased, and compared with the control group, the levels of IL-8, hs-CRP and TNF-?琢 in the observation group were all de- creased(P<0.05). The total effective rate of the patients in the observation group was 92.11%, which was significantly higher than 73.68% of the control group(P<0.05). There was no significant difference in the incidence of total adverse reactions between the obser- vation group and the control group(P>0.05). Conclusion: The combination of alprostadil and nimodipine in the treatment of aSAH afetr CVS can significantly improve the vascular endothelial function and reduce the levels of inflammatory factors, and the adverse reaction of the drug is not increased, the treatment effect is better. |
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