脑肽节苷脂联合尼莫地平治疗动脉瘤性蛛网膜下腔出血合并脑血管痉挛的临床效果

Clinical Effect of Cerebroside Combined with Nimodipine in the Treatment of Aneurysmal Subarachnoid Hemorrhage Complicated with Cerebral Vasospasm

目的:探讨脑肽节苷脂联合尼莫地平治疗动脉瘤性蛛网膜下腔出血(aSAH)合并脑血管痉挛(CVS)的临床效果。方法:选取2020年1月-2021年12月在粤北人民医院治疗的94例aSAH合并CVS患者为研究对象,编号后按照随机抽签的方式分为对照组(n=47)和观察组(n=47)。对照组给予尼莫地平治疗,观察组给予脑肽节苷脂联合尼莫地平治疗。采用格拉斯哥昏迷量表评分(GCS)评估两组治疗前后昏迷程度,比较两组大脑前动脉、中动脉、后动脉平均血流速度、生化指标[内皮素-1(ET-1)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)及白介素-8(IL-8)]及不良反应。结果:观察组治疗总有效率为91.49%(43/47),高于对照组的76.60%(36/47),差异有统计学意义(P<0.05)。观察组治疗后昏迷程度优于对照组(P<0.05)。治疗后,两组大脑前、中、后动脉平均血流速度及ET-1、VEGF、TNF-α、IL-8水平较治疗前均降低,且观察组均低于对照组(P<0.05)。两组不良反应发生率(17.02%vs 12.77%)比较,差异无统计学意义(P>0.05)。结论:脑肽节苷脂联合尼莫地平治疗aSAH合并CVS的效果显著,有助于改善患者意识障碍和血管内皮功能,降低炎症因子水平,且安全性良好。

Objective:To explore the clinical effect of Cerebroside combined with Nimodipine in the treatment of aneurysmal subarachnoid hemorrhage(aSAH)complicated with cerebral vasospasm(CVS).Method:A total of 94 patients with aSAH complicated with CVS who treated in Yue Bei People’s Hospital from January 2020 to December 2021 were selected as the research objects.After numbering,they were divided into the control group(n=47)and the observation group(n=47)by random drawing.The control group was treated with Nimodipine,and the observation group was treated with Cerebroside combined with Nimodipine.Glasgow coma scale(GCS)was used to evaluate the coma degree of two groups before and after treatment,the mean blood flow velocity of anterior cerebral artery,middle cerebral artery,posterior cerebral artery and biochemical indicators[endothelin-1(ET-1),vascular endothelial growth factor(VEGF),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)]before and after treatment and adverse reactions were compared between two groups.Result:The total effective rate of the observation group was 91.49%(43/47),which was higher than 76.60%(36/47)of the control group,the difference was statistically significant(P<0.05).The coma degree in the observation group after treatment was better than that in the control group(P<0.05).After treatment,the mean blood flow velocity of anterior cerebral artery,middle cerebral artery,posterior cerebral artery and the levels of ET-1,VEGF,TNF-αand IL-8 of two groups were lower than those before treatment,those of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(17.02%vs 12.77%)(P>0.05).Conclusion:The effect of Cerebroside combined with Nimodipine in the treatment of aSAH complicated with CVS is significant,which helps to improve patients’consciousness disorder and vascular endothelial function,reduce the level of inflammatory factors,and has good safety.