尼莫地平联合帕伐他汀预防蛛网膜下腔出血后脑血管痉挛的效果观察及对 ET-1、NO 的影响

Effect of Nimodipine combined with Pravastatin on preventing cerebral vasospasm after subarachnoid hemorrhage and its influence on ET-1 and NO

目的：探讨尼莫地平联合帕伐他汀预防蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）的效果及对内皮素-1（ET-1）、一氧化氮（NO）的影响。方法抽取解放军一五五中心医院2012年1月至2013年10月收治的60例蛛网膜下腔出血患者为研究对象，按照入院先后顺序将其分为两组，每组30例，对照组给予降颅压、止血等对症治疗，观察组在对照组的基础上行尼莫地平联合帕伐他汀治疗，比较两组脑血管痉挛、再出血发生率、治疗前后 ET-1及 NO 水平。结果观察组 CVS 发生率、病死率分别为6.67%、3.33%，与对照组比较差异有统计学意义（P ﹤0.05）。两组治疗后ET-1、NO 水平比较差异有统计学意义（P ﹤0.05）。结论尼莫地平联合帕伐他汀能有效预防SAH 后 CVS，可能机制为抑制 ET-1水平、提高 NO 水平。

Objective To investigate the effect of Nimodipine combined with Pravastatin on preventing the cerebral vasospasm after subarachnoid hemorrhage and its influence on ET-1 and NO. Methods Sixty patients with subarachnoid hemorrhage in our hospital from January 2012 to October 2013 were treated as the research objects,and they were divided into two groups,with 30 cases in each group according to admission order. The patients in control group were given lowering intracraninal pressure,stop bleeding treatment,the patients in observation group were given Nimodipine combined with Pravastatin treatment on the basis of treatment in the control group. The cerebral vasospasm,and incidence of bleeding,ET-1 and the NO level was compared before and after the treatment. Results CVS incidence and case fatality rate of observation group respectively was 6. 67% ,3. 33% ,compared with those in the control group（26. 67% ,20% ）,the differences were significant（ P ﹤ 0. 05 ）. In addition,ET-1,NO level difference was significant after treatment between the two groups（ P ﹤ 0. 05）. Conclusions Nimodipine combined with Pravastatin can effectively prevent the CVS after SAH,the possible mechanism maybe the inhibition of ET 1 level and improve the level of NO.