纳美芬联合依达拉奉对颅内动脉瘤血管栓塞术后患者的神经功能及血清NSE、MMP-2、ET-1影响观察

Effects of Nalmefene Combined with Edaravone on Neurological Function,Serum NSE,MMP-2 and ET-1 Levels in Patients with Intracranial Aneurysms after Vascular Embolotherapy

目的:观察纳美芬联合依达拉奉对颅内动脉瘤血管栓塞术后患者的神经功能及血清神经元特异烯醇化酶(NSE)、基质金属蛋白酶-9(MMP-9)和血浆内皮素-1(ET-1)水平的影响。方法:100例动脉瘤破裂致蛛网膜下腔出血后行血管栓塞术的患者随机分为观察组及对照组各50例。在常规治疗基础上,对照组给予依达拉奉治疗,观察组在对照组基础上加用纳美芬。治疗4周后,比较两组患者治疗前后脑水肿评分、神经功能缺损评分、Barthel指数评分、格拉斯哥昏迷量表评分(GCS)、脑中动脉血流速度,以及血清NSE、MMP-2、ET-1水平变化;观察两组患者治疗后格拉斯哥预后量表分级(GOS)和脑血管痉挛发生情况。结果:治疗后两组患者的脑水肿评分、神经功能缺损评分、Barthel指数评分、GCS评分、脑中动脉血流速度,以及血清NSE、MMP-2、ET-1水平均较治疗前明显改善(P<0.05),且观察组各项指标均明显优于对照组(P<0.05)。观察组的GOS评分和脑血管痉挛发生率也明显优于对照组(P<0.05)。结论:纳美芬联合依达拉奉用于颅内动脉瘤行血管栓塞术后患者,可显著改善神经功能,降低血清NSE、MMP-2、ET-1水平,且安全性好。

Objective:To analyze the effects of nalmefene combined with edaravone on neurological function,serum levels of neuron-specific enolase(NSE),matrix metalloproteinase-9(MMP)and plasma endothelin-1(ET-1)in patients with intracranial aneurysms after vascular embolotherapy.Methods:Totally 100 patients with intracranial aneurysms who underwent vascular embolotherapy after subarachnoid hemorrhage due to aneurysm rupture were divided into the observation group and the control group according to the random envelope method.On the basis of the conventional regimen,the control group was treated with edaravone.The observation group was treated with namefen on the basis of the control group.The cerebral edema score,neurological deficit score,Glasgow Coma scale score,Glasgow prognosis scale,Barthel index score,middle cerebral artery blood flow velocity and the occurrence of cerebral vasospasm were recorded before and after the treatment.The levels of serum NSE,MMP-2 and ET-1 were measured before and after the treatment.Results:After the treatment,the cerebral edema score,neurological deficit score,blood flow velocity of middle cerebral artery,incidence of cerebral vasospasm,and levels of NSE,MMP-2 and ET-1 in the observation group were significantly lower than those in the control group(P<0.05).Glasgow Coma scale score and Barthel index score in the observation group were significantly higher than those in the control group(P<0.05).Glasgow prognosis grade of the observation group was significantly better than that of the control group(P<0.05).Conclusion:Nalmefene combined with edaravone can significantly improve neurological function and reduce serum levels of NSE,MMP-2 and ET-1 in patients with intracranial aneurysms after vascular embolotherapy.