瑞舒伐他汀联合法舒地尔对破裂颅内动脉瘤栓塞术后患者DCVS发生率、MCA流速及生活质量的影响

Effects of Rosuvastatin Combined with Fasudil on DCVS Incidence Rate,MCA Blood Flow Velocity and Quality of Life of Patients with Ruptured Intracranial Aneurysms after Embolization

目的探讨瑞舒伐他汀联合法舒地尔对破裂颅内动脉瘤栓塞术后患者迟发性脑血管痉挛(DCVS)发生率、大脑中动脉(MCA)流速及生活质量的影响。方法研究对象选取西电集团医院2014年3月—2016年3月收治的破裂颅内动脉瘤栓塞术后患者共120例,以治疗方法不同分为对照组(60例)和观察组(60例)。分别给予瑞舒伐他汀单用和在此基础上加用法舒地尔辅助治疗,比较两组DCVS发生率,治疗前后MCA血流速度、Barthel指数评分、Glasgow昏迷评分(GCS)、Glasgow预后评分(GOS)分级情况及不良反应发生率。结果观察组DCVS发生率显著低于对照组(P<0.05)。两组治疗后MCA血流速度、Barthel指数评分及GCS评分均高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。观察组术后GOS分级情况显著优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论瑞舒伐他汀联合法舒地尔治疗破裂颅内动脉瘤栓塞术后患者,可有效避免DCVS发生,增加脑组织血流灌注水平,提高生活质量,改善临床预后,且未加重药物不良反应。

Objective To investigate effects of Rosuvastatin combined with Fasudil on delayed cerebral vascular spasm （DCVS） incidence rate, middle cerebral artery （MCA） blood flow velocity and quality of life of patients with ruptured intracranial aneurysms after embolization. Methods A total of 120 patients with ruptured intracranial aneurysms after embolization during March 2014 and March 2016 were divided into control group （ n = 60） and observation group （n = 60） according to treatment methods. Control group was treated with Rosuvastatin only, while observation group was treated with Rosuvastatin combined with Fasudil. DCVS incidence rate, MCA blood flow velocity, Barthel index scores, Glasgow coma score （GCS） , classification conditions of Glasgow outcome scale （GOS） and incidence rate of adverse reaction before and after treatment were compared in two groups. Results DCVS incidence rate in observation group was significantly lower than that in control group （P 〈 0.05 ）. After treatment, values of MCA blood flow velocity, Barthel index scores and GCS were significantly higher than those before treatment in both groups （P 〈 0. 05） , and the above values in observation group were significantly higher than those in control group （ P 〈 0.05 ）. The postoperative GOS classification in observation group was significantly better than that in control group （ P 〈 0. 05 ）. There was no significant difference in incidence rate of adverse reaction between two groups （P 〉 0. 05）. Conclusion Rosuvastatin combined with Fasudil in treatment of patients with ruptured intracranial aneurysms after embolization can efficiently avoid the DCVS occurrence, increase levels of cerebral blood perfusion, improve quality of life and clinical outcomes without aggravating adverse drug reactions.