尼莫地平与乌司他丁联合治疗外伤性蛛网膜下腔出血的临床研究

Effects of Nimodipine and Ulinastatin on Serum TNF-α,IL-6 and IL-8 Levels in Patients with Traumatic Subarachnoid Hemorrhage

目的探讨尼莫地平与乌司他丁联合治疗外伤性蛛网膜下腔出血的临床意义。方法88例外伤性蛛网膜下腔出血患者随机分为三组,联合治疗组(30例)在常规治疗基础上给予尼莫地平与乌司他丁联合治疗,尼莫地平组(30例)在常规治疗基础上给予尼莫地平,常规治疗组(28例)为对照组,分别于伤后3、5、7d采用放射免疫法测定血清TNF-α、IL-6、IL-8水平作为观察指标,比较三组的治疗效果。结果联合治疗组血清TNF-α、IL-6、IL-8含量在伤后3、5、7d时间点都比对照组及尼莫地平组低(P<0.05);伤后10d联合治疗组和尼莫地平组神经功能评分(GCS评分)较对照组显著增高(P<0.05)。结论尼莫地平与乌司他丁联合治疗外伤性蛛网膜下腔出血疗效显著,可以降低颅脑损伤早期血清TNF-α、IL-6、IL-8的水平,有利于神经功能的恢复和改善预后。

Objective To explore the effects of Nimodipine in Combination with Ulinastatin on serum tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and IL-8 levels in the patients with traumatic subarachnoid hemorrhage （tSAH）. Methods Eighty-eight patients with tSAH were randomly divided into three groups, i.e. treatment group with nimodipine and ulinastatin （30 patients）, nimodipine group （30 patients） and control group （28 patients）. GCS was determined in all the patients within 12 hours and 10 days after the injury. The serum TNF-α, IL-6 and IL-8 levels were determined by radioimmunoassay 3, 5 and 7 days after the injury in all the patients. Results The serum TNF-α, IL-6 and IL-8 levels were significantly lower in treatment group with nimodipine and ulinastatin than those of the control and Nimodipine groups 3, 5 and 7 days after the injury. GCS was significantly higher in treatment group with nimodipine and ulinastatin than that of the control and Nimodipine groups 10 days after the injury. Conclusion The treatment by Nimodipine Combined with ulinastatin can reduce the serum TNF-α, IL-6 and IL-8 levels and improve nervous function in the patients with tSAH.