清开灵注射液联合马来酸桂哌齐特治疗蛛网膜下腔出血后脑血管痉挛的效果

Effect Research of Qingkailing Injection Combined with Cinepazide Maleate in Treating Cerebral Vasospasm after Subarachnoid Hemorrhage

目的:探讨清开灵注射液联合马来酸桂哌齐特治疗蛛网膜下腔出血后脑血管痉挛的效果及对血清可溶性细胞间黏附分子-1(sICAM-1)和超敏C反应蛋白(hs-CRP)水平的影响。方法:筛选2017年2月-2019年2月在笔者所在医院就诊的自发性蛛网膜下腔出血后脑血管痉挛患者共66例,按随机数字表法分为对照组和观察组,每组33例。两组均给予常规治疗措施,对照组给予马来酸桂哌齐特注射液,4支/次,1次/d;观察组在对照组治疗基础上加用清开灵注射液,20~40 ml/d。两组疗程均为14 d。比较两组患者的脑血流速度、临床疗效及血清sICAM-1和hs-CRP水平。结果:与对照组比较,观察组患者治疗后的大脑中动脉、大脑前动脉及大脑后动脉的血流速度降低更显著(P<0.01);观察组和对照组的临床总有效率分别为93.94%和69.70%,两组总有效率比较差异有统计学意义(P<0.05);与对照组比较,观察组患者血清sICAM-1和hs-CRP水平降低更明显(P<0.01)。结论:清开灵注射液联合马来酸桂哌齐特可有效降低蛛网膜下腔出血后脑血管痉挛患者的脑血流速度,缓解脑血管痉挛,抑制血清sICAM-1和hs-CRP炎性因子水平,疗效显著。

Objective: To investigate the efficacy of Qingkailing Injection combined with Cinepazide Maleate in treating cerebral vasospasm after subarachnoid hemorrhage, and its effect on serum levels of soluble intercellular adhesion molecule-1(sICAM-1) and hypersensitive C reactive protein(hs-CRP). Method: A total of 66 patients with cerebral vasospasm after spontaneous subarachnoid hemorrhage who were treated in our hospital from February 2017 to February 2019 were selected. They were divided into control group and observation group according to random number table method with 33 cases in each group. Two groups were given with routine treatment measures. The control group was given with Cinepazide Maleate Injection with 4 doses/time, 1 time per day. In the observation group, Qingkailing injection was added on the basic of the control group, 20-40 ml per day. Both groups were treated for 14 days. The cerebral blood flow, the efficacy, and serum levels of sICAM-1 and hs-CRP were compared between the two groups. Result: Compared with the control group, the flow velocity of middle cerebral artery, anterior cerebral artery, and posterior cerebral artery in the observation group decreased significantly after treatment(P<0.01). The total clinical effective rate of the observation group and the control group were 93.94% and 69.70%, respectively, and the difference in the total effective rate between the two groups was statistically significant(P<0.05). Compared with the control group, the serum SICAM-1 and hs-CRP levels in the observation group were significantly reduced(P<0.01). Conclusion: Qingkailing Injection combined with Cinepazide Maleate in treating cerebral vasospasm after subarachnoid hemorrhage can reduce the cerebral blood flow velocity of patients, relieve cerebral vasospasm, and inhibit the serum levels of sICAM-1 and hs-CRP. It has significant efficacy.