尼莫地平联合甘露醇对老年高血压脑出血患者血清IL-1β、TNF-α及肾功能的影响

Effects of nimodipine combined with mannitol on serum IL-1β, TNF-α and renal function in eld- erly patients with hypertensive intracerebral hemorrhage

目的 探讨尼莫地平联合甘露醇对老年高血压脑出血（HICH）患者血清白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）及肾功能的影响。方法 选取94例老年HICH患者，依据治疗方案分为两组，每组47例。单一组给予甘露醇治疗，联合组给予甘露醇＋尼莫地平治疗。观察两组治疗效果，并对比两组治疗前后神经功能（NIHSS）恢复情况，血清IL-1β、TNF-α水平及肾功能[血肌酐（Cr）、尿素氮（BUN）]指标变化情况。结果 联合组治疗总有效率为95.74%（45/47），优于单一组的78.72%（37/47），差异有统计学意义（P〈0.05）；两组治疗后NIHSS评分，血清TNF-α、IL-1β水平均显著下降，且联合组NIHSS评分，血清TNF-α、IL-1β水平均低于单一组，差异有统计学意义（P〈0.05）；两组治疗后血Cr、BUN水平均有所升高，但组间比较差异未见统计学意义（P〉0.05）。结论 尼莫地平联合甘露醇治疗HICH患者，可显著提高治疗效果，有效降低血清TNF-α、IL-1β水平，促进神经功能恢复，且不会加剧患者肾功能损伤。

Objective To investigate the effects of nimodipine combined with mannitol on serum interleukin-1β （IL-1β）, tumor necrosis factor-α （TNF-α） and renal function in elderly patients with hypertensive intracerebral hemorrhage （HICH）.Methods Ninety-four elderly patients with HICH were divided into single group and combined group according to the treatment regimen and 47 patients in each group. The single group was treated with mannitol and the combined group was treated with mannitol ＋ nimodipine. The effects of the two groups were observed, and the recovery of neurological function （NIHSS）, changes of serum IL-1β, TNF-α levels and renal function [blood creatinine （Cr）, urea nitrogen （BUN）]before and after treatment were compared.Results The total effective rate in the combined group[95.74% （45/47）]was significantly better than that in the single group （78.72%, 37/47） （P〈0.05）; NIHSS score and serum TNF-α and IL-1β levels were significantly decreased after treatment, NIHSS score, serum TNF-α, IL-1β levels of the combined group were lower than those of the single group, the differences were significant （P〈0.05）; the levels of Cr and BUN increased after treatment, but there was no significant difference between the two groups （P〉0.05）.Conclusions Nimodipine combined with mannitol in treatment of HICH can significantly improve the therapeutic effect, reduce the levels of serum TNF-α and IL-1β, and promote the recovery of neurological function, and it will not aggravate renal injury.