前列地尔联合尼麦角林治疗后循环缺血性眩晕的临床疗效观察

Clinical Effect of Alprostadil Combined with Nicergoline on Posterior Circulation Ischemic Vertigo

目的观察前列地尔联合尼麦角林治疗后循环缺血性眩晕(PCIV)的临床疗效。方法选取2013年10月—2014年10月武汉市第十一医院收治的128例PCIV患者,随机分为观察组65例和对照组63例。两组患者入院后给予阿司匹林肠溶片、他汀类药物、钙离子拮抗剂等常规治疗。对照组患者在常规治疗基础上给予尼麦角林治疗,观察组患者在对照组基础上联合前列地尔治疗。比较两组患者治疗第3天、第7天临床疗效,治疗前、治疗第3天、治疗第7天眩晕障碍调查表(DHI)评分,治疗前、治疗第7天左侧椎动脉、右侧椎动脉、基底动脉流速,不良反应发生情况。结果治疗第3天、第7天观察组患者临床疗效均优于对照组(P<0.05)。治疗前两组患者DHI评分比较,差异无统计学意义(P>0.05);治疗第3天、第7天观察组患者DHI评分均低于对照组(P<0.05)。治疗前两组患者左侧、右侧椎动脉及基底动脉流速比较,差异无统计学意义(P>0.05);治疗第7天观察组患者左侧、右侧椎动脉及基底动脉流速均高于对照组(P<0.05)。两组患者均未出现明显肝功能异常、血肌酐升高等不良反应。结论前列地尔联合尼麦角林治疗PCIV的临床疗效确切,能有效改善患者生活质量及椎动脉系统血流动力学,减轻患者焦虑情绪。

Objective To investigate the clinical effect of alprostadil combined with nicergoline on posterior circulation ischemic vertigo（ PCIV）. Methods A total of 128 patients with PCIV were selected in the Eleventh Hospital of Wuhan from October 2013 to October 2014,and they were randomly divided into observation group（n=65）and control group（n=63）. Patients of both groups were given conventional treatment,including aspirin enteric tablets,statins,calcium channel blockers and so on after admission, patients of control group were given extra nicergoline, patients of observation group were given alprostadil combined with nicergoline. Clinical effect after 3 days,7 days of treatment were compared between the two groups, Dizziness Handicap Inventory（ DHI） was used to evaluate the illness severity before treatment and after 3 days,7 days of treatment,blood flow velocityof left vertebral artery,right vertebral artery and basilar artery were detected before treatment and after 7 days of treatment,and incidence of adverse reactions were recorded during treatment. Results The clinical effect of observation group was statistically significantly better than that of control group after 3 days,7 days of treatment,respectively（ P﹤0. 05）. No statistically significant difference of DHI score was found between the two groups before treatment（P﹥0. 05）, while DHI score of observation group was statistically significantly higher than that of control group after 3 days,7 days of treatment,respectively（P﹤0. 05）. No statistically significant difference of blood flow velocity of left vertebral artery,right vertebral artery or basilar artery was found between the two groups before treatment,while above index of observation group were significantly higher than those of control group after 7 days of treatment（P﹤0. 05）. No one of the two groups occurred obvious dysfunction of liver or Scr elevation during treatment. Conclusion Alprostadil combined with nicergoline has certain clinical effect on posterior PCIV,which can improve the patients＇quality of life and haemodynamics of vertebral arterial system,relieve the patients＇anxiety.