尼莫地平联合苯磺酸氨氯地平治疗中老年高血压脑出血的效果观察

Effects of nimodipine combined with amlodipine besylate on middle-aged and elderly patients with hypertensive intracerebral hemorrhage

目的探讨尼莫地平联合苯磺酸氨氯地平治疗中老年高血压脑出血的临床效果。方法抽取2017年4月至2019年4月在鹤壁市人民医院治疗的98例中老年高血压脑出血患者进行分组研究,随机分为单一组(n=49)与联合组(n=49),单一组予以尼莫地平治疗,联合组予以尼莫地平联合苯磺酸氨氯地平治疗,治疗2周,比较两组血肿体积、水肿面积、神经功能损伤情况以及预后情况的变化。结果治疗前,联合组与单一组血肿体积、水肿面积比较,差异未见统计学意义(P>0.05),经治疗1周、2周,联合组血肿体积、水肿面积小于单一组(P<0.05);治疗前,联合组与单一组美国国立卫生院卒中量表(NIHSS)评分、神经元特异性烯醇化酶(NSE)、星形胶质源性蛋白(S100β)水平比较,差异未见统计学意义(P>0.05),经治疗,联合组NIHSS评分、NSE、S100β水平低于单一组(P<0.05);治疗前,联合组与单一组日常生活能力评分(ADL)、格拉斯哥预后评分(GOS)、改良Rankin评分(mRS)评分比较,差异未见统计学意义(P>0.05),经治疗,联合组ADL、GOS评分高于单一组(P<0.05),mRS评分显著低于单一组(P<0.05)。结论尼莫地平联合苯磺酸氨氯地平治疗中老年高血压脑出血患者具有较好疗效,可显著缓解脑出血、水肿症状,减轻神经功能损伤,改善患者预后。

Objective To analyze the effects of nimodipine combined with amlodipine besylate on middle-aged and elderly patients with hypertensive intracerebral hemorrhage.Methods A total of 98 middle-aged and elderly patients with hypertensive intracerebral hemorrhage treated in Hebi People's Hospital from April 2017 to April 2019 were grouped for study,and they were randomly divided into single group(n=49)and combined group(n=49).Single group was given nimodipine,and combined group was treated with nimodipine+amlodipine besylate,and they were treated for 2 weeks.The hematoma volume,edema area,neurological damage and prognosis were compared between the two groups.Results Before treatment,there were no significant differences between combined group and single group in the hematoma volume and edema area(P>0.05).After 1 week and 2 weeks of treatment,the hematoma volume and edema area in combined group were significantly lower than those in single group(P<0.05).Before treatment,there was no significant difference in the National Institutes of Health Stroke Scale(NIHSS)score,neuron specific enolase(NSE)and astroglial derived protein(S100β)between combined group and single group(P>0.05).After treatment,the NIHSS score and levels of NSE and S100βin combined group were significantly lower than those in single group(P<0.05).Before treatment,there were no significant differences between combined group and single group in the scores of ability of daily living(ADL)and Glasgow outcome score(GOS)and modified Rankin score(MRS),the differences were not statistically significant(P>0.05).After treatment,the scores of ADL and GOS in combined group were significantly higher than those in single group(P<0.05)while the mRS score was significantly lower than that in single group(P<0.05).Conclusions Nimodipine combined with amlodipine besylate has good efficacy on middle-aged and elderly patients with hypertensive intracerebral hemorrhage,and it can significantly alleviate the symptoms of cerebral hemorrhage and edema,reduce neurological damage,and improve prognosis.