Rho激酶抑制剂的血流动力学急性效应对急性缺血性脑卒中神经介入治疗的影响

Effects of acute hemodynamic effect of Rho kinase inhibitors on neuro-interventional therapy in patients with acute ischemic stroke

目的探讨Rho激酶抑制剂法舒地尔的血流动力学急性效应对急性缺血性脑卒中(acute ischemic stroke,AIS)神经介入治疗的影响。方法将2015年1月至2017年8月收治的120例AIS病人根据随机数字表法分为3组,每组40例,A组采用神经介入术治疗,B组采用神经介入术联合30 mg法舒地尔治疗,C组采用神经介入术联合60 mg法舒地尔治疗。比较3组疗效及血流动力学变化,并分析血流动力学指标与疗效的相关性。结果 B、C组治疗有效率显著高于A组(P <0. 05)。B、C组的NIHSS评分、日常生活能力量表(ADL)评分、梗死体积、相对表观弥散系数(rADC)值和治疗前后动脉平均血流速度(Vm)差值均优于A组,且C组上述指标均优于B组,差异具有统计学意义(P <0. 05)。治疗前后动脉V_m差值与治疗后NIHSS评分、梗死体积均呈负相关(P <0. 001),与ADL评分、rADC值均呈正相关(P <0. 001)。结论 Rho激酶抑制剂的血流动力学急性效应呈剂量依赖性,能够减轻AIS脑梗死体积,改善神经功能,提高治疗效果。

Objective To explore the effects of acute hemodynamic effect of Rho kinase inhibitors on neuro-interventional therapy in the patients with acute ischemic stroke(AIS). Methods A total of 120 patients with AIS admitted from January 2015 to August 2017 were divided into three groups according to random number table,with 40 patients in each group. Group A was treated with neuro-intervention,group B was treated with 30 mg fasudil combined with neuro-intervention,group C was treated with 60 mg fasudil combined with neuro-intervention. The efficacy and hemodynamic changes were compared among the three groups,and the correlation between hemodynamic parameters and efficacy was analyzed. Results The efficiency of group B and group C was significantly higher than that of group A(P < 0. 05). National Institutes of Health Stroke Scale(NIHSS)score,activity of daily living scale(ADL)score,infarct volume,relative apparent diffusion coefficient(rADC)value and difference of mean blood flow velocity(V_m)before and after treatment in group B and group C were better than those in group A,and the above indexes in group C were better than those in group B(P < 0. 05). The difference of Vmbefore and after treatment was negatively correlated with NIHSS score and infarct volume(P < 0. 001),but positively correlated with ADL score and rADC value(P <0. 001). Conclusions The acute hemodynamic effect of Rho kinase inhibitor is dose-dependent,which can reduce the volume of AIS cerebral infarction,improve the neurological function and efficacy.