丁苯酞注射液联合法舒地尔注射液治疗脑动脉瘤栓塞术后脑血管痉挛的临床研究

Clinical trial of butylphthalide injection combined with fasudil injection in the treatment of cerebrovascular spasm after embolization of cerebral aneurysm

目的观察丁苯酞注射液联合法舒地尔注射液治疗脑动脉瘤栓塞术后脑血管痉挛的临床疗效及安全性。方法将92例脑动脉瘤栓塞术后脑血管痉挛患者随机分为对照组46例和试验组46例。对照组予以抗感染、镇静止咳、降颅内压、脱水等对症治疗;试验组在对照组治疗的基础上,予以丁苯酞每次100m L,qd,静脉滴注,持续治疗7 d+法舒地尔每次30 mg,tid,微泵持续静脉输注。2组患者均持续治疗14 d。比较2组患者的临床疗效,血清基质金属蛋白酶-2(MMP-2)、MMP-9和Caspase-3,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为91.30%(42例/46例)和76.09%(35例/46例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的血清MMP-2分别为(21.23±2.59)和(35.75±4.41)μg·L^(-1),MMP-9分别为(12.75±1.46)和(19.11±2.47)μmol·L^(-1),Caspase-3分别为(206.15±25.64)和(305.64±40.01)μg·L^(-1),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应主要有颜面潮红、低血压和恶心呕吐。试验组和对照组的总药物不良反应发生率分别为8.70%和17.39%,差异无统计学意义(P>0.05)。结论丁苯酞注射液联合法舒地尔注射液治疗脑动脉瘤栓塞术后脑血管痉挛的临床疗效确切,其能显著下调患者血清中MMP-2、MMP-9和Caspase-3的水平,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of butylphthalide injection combined with fasudil injection in the treatment of cerebrovascular spasm after embolization of cerebral aneurysm.Methods A total of 92 patients with cerebrovascular spasm after embolization of cerebral aneurysm were randomly divided into control and treatment groups with 46 cases per group.Control group was treated with antiinfection,sedation and cough,intracranial pressure and dehydration.Treatment group was given butylphthalide 100 m L per time,qd,intravenous drip＋fasudil 30 mg per time,tid,micropump continuous intravenous infusion.Two groups were treated for 14 d.The clinical efficacy,serum matrix metalloproteinase-2（MMP-2）,MMP-9 and Caspase-3,and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 91.30%（42 cases/46 cases）and 76.09%（35 cases/46cases）with significant difference（P〈0.05）.After treatment,the main indexes in treatment and control groups were compared：the serum MMP-2 were（21.23±2.59）and（35.75±4.41）μg·L^-1,MMP-9 were（12.75±1.46）and（19.11±2.47）μmol·L^-1,Caspase-3 were（206.15±25.64）and（305.64±40.01）μg·L^-1,the differences were statistically significant（all P〈0.05）.The adverse drug reactions of the two groups were facial flushing,hypotension and nausea and vomiting.The total incidences of adverse drug reactions in treatment and control groups were 8.70%and 17.39%without significant differences（P〉0.05）.Conclusion Butylphthalide injection combined with fasudil injection has a definitive clinical efficacy in the treatment of cerebrovascular spasm after embolization of cerebral aneurysm,which can significantly reduce the levels of serum MMP-2,MMP-9 and Caspase-3,without increasing the incidence of adverse drug reactions.