乌司他丁联合醒脑静注射液治疗急性重型高血压脑出血的临床研究

Clinical study on ulinastatin combined with Xingnaojing Injection in treatment of acute severe hypertensive intracerebral hemorrhage

目的探讨乌司他丁注射液联合醒脑静注射液治疗急性重型高血压脑出血的临床疗效。方法选取2015年3月—2019年2月在南阳市中心医院神经外科治疗的180例急性重型高血压脑出血患者为研究对象,所有患者随机分为对照组和治疗组,每组各90例。对照组患者静脉滴注醒脑静注射液,20 mL/次,1次/d;治疗组患者在对照组治疗基础上静脉滴注乌司他丁注射液,20万单位/次,2次/d,两药间隔1 h滴注。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的格拉斯哥昏迷(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分、血清炎症因子水平。结果治疗后,对照组与治疗组总有效率分别为67.78%、83.33%,两组比较差异有统计学意义(P<0.05)。治疗3、7、14d后,两组患者GCS评分均较治疗前升高,差异有统计学意义(P<0.05);治疗7、14 d后,治疗组患者GCS评分显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分明显下降,BI评分显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗组患者NHISS评分、BI评分均显著优于对照组,两组比较差异均具有统计学意义(P<0.05)。治疗后,两组患者血清超敏C反应蛋白(hs-CRP)、白细胞介素-1(IL-1)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)水平均较治疗前显著降低(P<0.05),且治疗组炎症因子水平显著低于对照组,差异有统计学意义(P<0.05)。结论乌司他丁注射液联合醒脑静注射液治疗急性重型高血压脑出血具有较好的临床疗效,可改善临床症状,增强炎症反应的抑制能力,提高生活质量,安全性较高,具有一定的临床推广应用价值。

Objective To explore clinical efficacy of Ulinastatin Injection combined with Xingnaojing Injection in treatment of acute severe hypertensive intracerebral hemorrhage. Methods Patients(180 cases) with acute severe hypertensive intracerebral hemorrhage in Nanyang Central Hospital from March 2015 to February 2019 were randomly divided into control and treatment groups, and each group had 90 cases. Patients in the control group were iv administered with Xingnaojing Injection, 20 mL/time, once daily. Patients in the treatment group were iv administered with Ulinastatin Injection on the basis of the control group, 200 000 U/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and GCS scores, NIHSS scores, BI scores, and the serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 67.78% and 83.33%, respectively, and there was difference between two groups(P < 0.05). After treatment for 3, 7, and 14 d, GCS scores in two groups were significantly increased, and the difference was statistically significant(P < 0.05). After treatment for 7 and 14 d, the GCS score in the treatment group was significantly higher than that in the control group, and the difference was statistically significant(P < 0.05). After treatment, NIHSS scores in two groups were significantly decreased, but BI scores in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the NIHSS score and BI score in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of hs-CRP, IL-1, IL-8, and TNF-α in two groups were significantly decreased(P < 0.05), and the serum level of inflammatory factors in the treatment group was significantly lower than that in the control group, and the difference was statistically significant in the same group(P < 0.05). Conclusion Ulinastatin Injection combined with Xingnaojing Injection has clinical curative effect in treatment of acute severe hypertensive intracerebral hemorrhage, can improve the clinical symptoms, enhance the inhibition ability of inflammatory reaction, and improve the quality of life, with good safety, which has a certain clinical application value.