發(fā)布時(shí)間：2018-02-25 05:16

  本文關(guān)鍵詞： 前列地爾 尼莫地平 蛛網(wǎng)膜下腔出血 腦血管痙攣 血管內(nèi)皮 炎癥因子 認(rèn)知功能　出處：《中國臨床藥理學(xué)雜志》2016年21期 　論文類型：期刊論文

【摘要】：目的觀察前列地爾注射液聯(lián)合尼莫地平注射液對動(dòng)脈瘤性蛛網(wǎng)膜下腔出血伴腦血管痙攣患者血管內(nèi)皮、炎癥因子及認(rèn)知功能的影響。方法 85例動(dòng)脈瘤性蛛網(wǎng)膜下腔出血伴腦血管痙攣患者按照隨機(jī)數(shù)字表法分為對照組42例和試驗(yàn)組43例。對照組在常規(guī)治療基礎(chǔ)上靜脈滴注前列地爾注射液10μg,加入0.9%Na Cl 100 m L,每天1次;試驗(yàn)組在對照組的基礎(chǔ)上靜脈滴注尼莫地平注射液50 m L,加入0.9%Na Cl 250 m L,每天1次。2組均治療14 d。治療后,觀察2組患者的臨床療效,測定患者血漿降鈣素基因相關(guān)肽(CGRP)和內(nèi)皮素-1(ET-1)的含量,檢測血清血管內(nèi)皮生長因子(VEGF)、腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素-8(IL-8)及超敏C反應(yīng)蛋白(hs-CRP)水平,用蒙特利爾認(rèn)知評估量表(MOCA)評估認(rèn)知功能。結(jié)果試驗(yàn)組的總有效率為90.70%(39/43例),對照組的總有效率為73.81%(31/42例,P0.05)。試驗(yàn)組CGRP為(55.56±8.44)pg·m L~(-1),VEGF為(123.35±34.83)ng·m L~(-1);對照組CGRP為(47.29±8.49)pg·m L~(-1),VEGF為(142.38±14.47)ng·m L~(-1)(P0.05)。試驗(yàn)組ET-1為(71.35±10.46)pg·m L~(-1),對照組ET-1為(91.81±11.70)pg·m L~(-1),2組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組TNF-α為(0.24±0.08)ng·m L~(-1),IL-8為(1.39±0.31)ng·m L~(-1),hs-CRP為(189.51±23.27)ng·m L~(-1);對照組TNF-α為(0.32±0.10)ng·m L~(-1),IL-8為(2.24±0.34)ng·m L~(-1),hs-CRP為(211.51±25.51)ng·m L~(-1),2組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組藥物不良反應(yīng)主要為胃腸道反應(yīng)、惡心嘔吐、頭暈頭痛、皮疹,試驗(yàn)組藥物不良反應(yīng)發(fā)生率為25.58%(11/43例),對照組為26.19%(11/42例),差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論前列地爾聯(lián)合尼莫地平可改善動(dòng)脈瘤性蛛網(wǎng)膜下腔出血伴腦血管痙攣患者血管內(nèi)皮功能,降低炎癥反應(yīng),增強(qiáng)認(rèn)知功能,有良好的臨床療效。
[Abstract]:Objective to observe the effect of alprostadil injection combined with nimodipine injection on vascular endothelium in patients with aneurysm subarachnoid hemorrhage and cerebral vasospasm. Methods Eighty-five patients with aneurysm subarachnoid hemorrhage associated with cerebral vasospasm were randomly divided into control group (n = 42) and experimental group (n = 43). Alprostadil injection 10 渭 g was injected intravenously with 0.9% NaCl 100ml, once a day. On the basis of the control group, the experimental group was given nimodipine injection 50 mL by intravenous drip, and 0.9 NaCl 250 mL was added to the experimental group. The treatment of group 2 was done once a day for 14 days. After treatment, the clinical efficacy of the two groups was observed. The plasma levels of calcitonin gene-related peptide (CGRP) and endothelin-1 (ET-1) were measured. The levels of serum vascular endothelial growth factor (VEGF), tumor necrosis factor- 偽 (TNF- 偽), interleukin-8 (IL-8) and hypersensitive C-reactive protein (hs-CRP) were measured. Results the total effective rate was 90.70% 39 / 43 cases in the trial group and 73.81% in 42 cases in the control group (P 0.05). The CGRP in the trial group was 55.56 鹵8.44 ng 路mL -1 CGRP was 123.35 鹵34.83 ng 路mL ~ (-1), the CGRP in the control group was 47.29 鹵8.49 PG 路m ~ (-1) CGRP was 142.38 鹵14.47 ng 路mL ~ (-1). The ET-1 in the trial group was 142.38 鹵14.47 ng 路mL ~ (-1). TNF- 偽 was 0.24 鹵0.08 ng 路mL -1 IL-8, 1.39 鹵0.31 ng 路mL -1 IL-8, 189.51 鹵23.27 ng 路mL -1 in control group, 0.32 鹵0.10 ng 路mL ~ (-1) in control group, 2.24 鹵0.34 ng 路mL ~ (-1) in TNF- 偽 and 11.251 鹵25.51 ng 路L ~ (-1) L ~ (-1) CRP in the control group, respectively. There were significant differences in the adverse reactions of stomach and stomach in the control group (TNF- 偽 = 0.32 鹵0.10 ng 路m ~ (-1)). The level of IL-8 was 2.24 鹵0.34 ng 路mL ~ (-1) in the trial group, and the significant difference was (11.251 鹵25.51) ng 路m ~ (-1) L ~ (-1) in the gastric side effects in the control group (P < 0.05), and in the control group, the TNF- 偽 was 0.32 鹵0.10 ng 路m ~ (-1). The level of IL-8 in the intestinal tract was 2.24 鹵0.34 ng 路m ~ (-1). Nausea, vomiting, dizziness, headache, rash, The incidence of adverse drug reactions in the trial group was 25.58 / 11 / 43, while in the control group was 26.19 / 11 / 42, with no significant difference (P 0.05). Conclusion alprostadil combined with nimodipine can improve vascular endothelial function in patients with aneurysm subarachnoid hemorrhage and cerebral vasospasm. Reduce inflammatory reaction, enhance cognitive function, has good clinical efficacy.
【作者單位】： 嘉興市第二醫(yī)院神經(jīng)外科;浙江大學(xué)附屬第二醫(yī)院神經(jīng)外科;
【分類號】：R743.35

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王靜,焦桂萍;前列地爾注射液治療老年人椎—基底動(dòng)脈供血不足[J];貴州醫(yī)藥;2001年09期

2 張春馳;董艷娟;何躍;賀昕;;前列地爾注射液對短暫性腦缺血發(fā)作腦血流變化的影響[J];疑難病雜志;2014年05期

3 徐玉根;;前列地爾注射液對急性腦梗塞患者血液流變學(xué)的影響[J];醫(yī)學(xué)信息(中旬刊);2010年05期

4 于明;張凱博;;前列地爾合并丹紅注射液治療老年椎-基底動(dòng)脈系統(tǒng)短暫性腦缺血所致眩暈的療效觀察[J];解放軍藥學(xué)學(xué)報(bào);2010年03期

5 姚細(xì)蕊;;前列地爾注射液治療急性腦梗死的療效觀察[J];中國現(xiàn)代藥物應(yīng)用;2013年18期

6 郭建隊(duì);邊瑩;;前列地爾注射液治療急性腦梗死60例[J];陜西醫(yī)學(xué)雜志;2012年05期

7 唐集敏;;前列地爾注射液治療腦梗死的臨床研究概況[J];中國現(xiàn)代藥物應(yīng)用;2013年15期

8 馬瑤;李嘉琦;李莉;龐永霞;楊博;;前列地爾注射液治療急性腦梗死的療效觀察[J];解放軍藥學(xué)學(xué)報(bào);2010年03期

9 姚芳;何賓;;前列地爾注射液治療腦梗塞68例臨床觀察[J];中國醫(yī)療前沿;2012年12期

10 焦麗強(qiáng);于明克;陳宗躍;;前列地爾注射液輔助治療急性腦梗死的臨床觀察[J];中國臨床醫(yī)生;2013年08期

，

本文編號：1533139