强化胰岛素联合维生素C治疗对t-SAH患者ET-1、NO的影响

Effect of intensive insulin combined with vitamin C therapy on ET-1, NO in traumatic subarachnoid hemorrhage patients

目的探讨强化胰岛素联合维生素C治疗对外伤性蛛网膜下腔出血后脑血管痉挛的作用。方法通过对t-SAH患者随机予以强化胰岛素联合维生素C治疗(治疗1组)、尼莫地平针治疗(治疗2组)或常规治疗(对照组),在第1、4、7、14天留取患者血浆和脑脊液,测定血浆和脑脊液中内皮素-1(ET-1)、一氧化氮浓度(NO),并同时采用经颅多普勒监测大脑中动脉平均流速,并进行对比及统计学分析。结果与对照组比较,治疗1组及治疗2组血浆和脑脊液中ET-1明显降低、NO浓度明显升高,大脑中动脉平均流速明显下降,有统计学意义(P<0.05)。结论强化胰岛素联合维生素C治疗可以作为外伤性脑血管痉挛防治的有效手段。

Objective To investigate the effect of intensive insulin combined with vitamin C therapy on cerebral vasospasm following trau- matic subarachnoid hemorrhage. Methods Patients were randomly divided into the intensive insulin combined with vitamin C group （group 1）, ni- modipine group （group 2） or conventional treatment （control group）. Then the endothelin-l（ET-1） and nitric oxide（NO） concentration in plasma and cerebrospinal fluid were recorded on the following 1, 4, 7, 14 days, and at the same time the mean velocity of middle cerebral artery （MCA） was also recorded by transeranial doppler. Results Compared with the control group, in group 1 and group 2 ET-1 decreased significantly （P〈0.05）, NO in- creased significantly（P〈0.05）, mean flow velocity of MCA decreased significantly（P〈0.05）. Conclusion Intensive insulin combined with vitamin C therapy can be an effective mean of traumatic cerebral vasospasm.