七叶皂苷钠联合尼卡地平治疗高血压脑出血临床观察

Clinical Observation on Sodium Aescinate Combined with Nicardipine in the Treatment of Hypertensive Cerebral Hemorrhage

目的探讨七叶皂苷钠联合尼卡地平治疗高血压脑出血的临床疗效。方法按随机数字表法将医院2015年2月至2017年11月收治的103例高血压脑出血患者分为对照组(51例)和试验组(52例)。在对症治疗基础上,两组患者均予盐酸尼卡地平注射液,试验组患者加用注射用七叶皂苷钠,均治疗14 d。结果试验组总有效率为92. 31%,明显高于对照组的76. 47%(P <0. 05);治疗后,两组患者残留血量、脑水肿体积显著小于治疗前,且试验组小于对照组(P <0. 05);治疗后,两组患者血钙水平升高,血肌酐、水通道蛋白1(AQP-1)、水通道蛋白4(AQP-4)水平均显著降低,且试验组均优于对照组(P <0. 05);治疗后,两组患者痴呆量表评分、Barthel指数、美国国立卫生研究院卒中量表(NIHSS)评分均较治疗前改善,且试验组改善幅度更优(P <0. 05);试验组与对照组不良反应发生率相当(7. 69%比9. 80%,P> 0. 05)。结论七叶皂苷钠联合卡地平治疗高血压脑出血,可显著提高临床疗效,改善血钙、血肌酐、AQP-1、AQP-4水平。

Objective To investigate the clinical effect of sodium aescinate combined with nicardipine in the treatment of hypertensive cerebral hemorrhage. Methods Totally 103 patients with hypertensive cerebral hemorrhage admitted to our hospital from February 2015 to November 2017 were divided into the control group( 51 cases) and the experimental group( 52 cases) according to the random number table method. On the basis of symptomatic treatment,the patients in the two groups were treated with Nicardipine Hydrochloride Injection,on this basis,the patients in the experimental group were treated with Sodium Aescinate for Injection. Both groups were treated for 14 d. Results The total effective rate of the experimental group was 92. 31%,which was significantly higher than 76. 47 % of the control group( P < 0. 05). After treatment,the residual blood volume and brain edema volume of the two groups were significantly less than those before treatment,and those of the experimental group were less than those of the control group( P < 0. 05). After treatment,the level of serum calcium in the two groups was significantly increased,while the levels of serum creatinine,aquaporin 1( AQP-1),AQP-4 in the two groups were significantly decreased,those in the experimental group were significantly better than those in the control group( P < 0. 05). After treatment,the dementia scale score,Barthel index and National Institutes of Health stroke scale( NIHSS)score in the two groups were improved,and the improvement in the experimental group was better than that of the control group( P < 0. 05).The incidence of adverse reactions in the observation group was similar to that in the control group( 7. 69% vs. 9. 80 %,P > 0. 05).Conclusion Sodium aescinate combined with nicardipine can significantly improve the clinical effect,serum calcium,creatinine,the levels of AQP-1 and AQP-4 in patients with hypertensive cerebral hemorrhage.