依达拉奉与尼莫地平联合治疗高血压脑出血的疗效及对相关因子水平的影响

Efficacy of Edaravone Combined with Nimodipine in Treatment of Hypertensive Cerebral Hemorrhage and its Effect on the Level of Related Factors

目的:探讨依达拉奉与尼莫地平联合治疗高血压脑出血的疗效及对相关因子水平的影响。方法:回顾性分析2017年1月至2018年4月解放军陆军军医大学第二附属医院、重庆医科大学附属大学城医院及重庆医科大学附属永川医院收治的高血压脑出血患者142例的临床资料,按照治疗方式的差异分为观察组72例和对照组70例。对照组患者均接受常规治疗,观察组患者在对照组的基础上加用依达拉奉与尼莫地平。比较治疗14 d后两组患者的临床疗效,同时观察两组患者治疗前后美国国立卫生院卒中神经功能缺损评分量表(national institutes of health stroke scale,NIHSS)评分、平均动脉压(MAP)、血管生长因子(VEGF)水平、血肿及水肿体积和血流动力学指标水平[前动脉、双侧大脑中动脉的平均流速(Vm)和收缩期峰值血流速度(Vs)]的变化情况。结果:治疗后,观察组患者的总有效率为90.28%(65/72),明显高于对照组的68.57%(48/70),差异有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分、MAP水平较治疗前明显降低,VEGF水平较治疗前明显升高;且观察组患者NIHSS评分、MAP水平明显低于对照组,VEGF水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血肿、水肿体积较治疗前明显缩小,且观察组患者明显小于对照组,差异均有统计学意义(P<0.05);两组患者前动脉、双侧大脑中动脉的Vm和Vs水平明显高于治疗前,且观察组患者明显高于对照组,差异均有统计学意义(P<0.05)。结论:依达拉奉与尼莫地平联合治疗,能有效改善高血压脑出血患者的神经功能和血流动力学,调节VEGF的表达,稳定患者血压,临床疗效显著。

OBJECTIVE: To probe into the efficacy of edaravone combined with nimodipine in treatment of hypertensive cerebral hemorrhage and its effect on the level of related factors. METHODS: Clinical data of 142 patients with hypertensive cerebral hemorrhage admitted into the Second Affiliated Hospital Army Medical University of PLA, University-Town Hospital of Chongqing Medical University and Yongchuan Hospital of Chongqing Medical University from Jan. 2017 to Apr. 2018 were retrospectively analyzed. The 142 patients were divided into observation group(72 cases) and control group(70 cases) according to different therapeutic regimens, the control group was given conventional therapy, while the observation group was given edaravone combined with nimodipine based on the control group. After 14-day treatment, the clinical efficacy of two groups were compared, scores of national institutes of health stroke scale(NIHSS), mean arterial pressure(MAP), vascular endothelial growth factor(VEGF), volumes of hematoma and edema, levels of hemodynamics indices [mean velocity of anterior artery and bilateral middle cerebral artery(Vm), peak systolic velocity(Vs)] of two groups before and after treatment were observed. RESULTS: After treatment, the total effective rate of observation group was 90.28%(65/72), which was significantly higher than that of the control group(68.57%, 48/70), with statistically significant difference(P<0.05). After treatment, the NIHSS scores and MAP levels of both groups were significantly lower than those of before treatment, the VEGF level was significantly higher than that of before treatment;the NIHSS score and MAP level of observation group were significantly lower than those of the control group, and the VEGF level was significantly higher than that of the control group, with statistically significant differences(P<0.05). After treatment, the volumes of hematoma and edema of both groups had been significantly decreased, and that of the observation group was significantly less than the control group, with statistically significant differences(P<0.05);the Vm and Vs levels of both groups were significantly higher than those of before treatment, and those of the observation group were significantly higher than the control group, with statistically significant differences(P<0.05). CONCLUSIONS: Edaravone combined with nimodipine can effectively improve the neurological function and hemodynamics of patients with hypertensive cerebral hemorrhage, regulate the expression of VEGF, stabilize patients’ blood pressure, with significant clinical efficacy.