法舒地尔联合丁苯酞对老年颅内动脉瘤术后血管痉挛的效果研究

Study on effect of fasudil combined with butylphthalide on vasospasm after intracranial aneurysms surgery in the elderly

目的分析法舒地尔联合丁苯酞对老年颅内动脉瘤术后血管痉挛的临床效果。方法126例老年颅内动脉瘤术后血管痉挛患者,按用药方法不同分为对照组与观察组,各63例。对照组在常规治疗的基础上应用盐酸法舒地尔注射液治疗,观察组在对照组基础上使用丁苯酞氯化钠注射液治疗。比较两组患者治疗前后的脑神经因子[脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、星形细胞钙结合蛋白(S100β)]水平、临床效果、治疗前后的脑血流动力学指标(大脑后动脉血流速度、大脑中动脉血流速度、大脑前动脉血流速度)。结果治疗后,观察组BDNF(3.37±0.68)ng/ml高于对照组的(2.52±0.51)ng/ml,NSE(13.89±4.65)U/ml、S100β(1.54±0.23)μg/L低于对照组的(18.43±5.31)U/ml、(2.28±0.27)μg/L,差异均有统计学意义(P<0.05)。观察组治疗总有效率为90.48%,高于对照组的74.60%,差异有统计学意义(P<0.05)。治疗后,观察组大脑后动脉血流速度、大脑中动脉血流速度、大脑前动脉血流速度分别为(73.37±8.77)、(80.17±13.39)、(64.08±11.97)cm/s,均低于对照组的(78.05±9.82)、(88.28±13.03)、(72.39±12.72)cm/s,差异有统计学意义(P<0.05)。结论老年颅内动脉瘤术后血管痉挛患者采用法舒地尔联合丁苯酞治疗可取得满意效果,具有进一步在临床上推广及应用的价值。

Objective To analyze the clinical effect of fasudil combined with butylphthalide on vasospasm after intracranial aneurysms surgery in the elderly.Methods A total of 126 patients with vasospasm after endovascular treatment of intracranial aneurysms were divided into control group and observation group according to different medication methods,with 63 cases in each group.The control group was treated with fasudil hydrochloride injection on the basis of routine treatment,and the observation group was treated with butylphthalide and sodium chloride injection on the basis of the control group.Both groups were compared in terms of levels of brain nerve factors[brain-derived neurotrophic factor(BDNF),neuronspecific enolase(NSE),calcium binding protein(S100β)]before and after treatment,clinical effect,and cerebral hemodynamic indicators(posterior cerebral artery blood flow velocity,middle cerebral artery blood flow velocity,anterior cerebral artery blood flow velocity)before and after treatment.Results After treatment,the BDNF(3.37±0.68)ng/ml in the observation group was higher than(2.52±0.51)ng/ml in the control group;the NSE(13.89±4.65)U/ml and S100β(1.54±0.23)μg/L in the observation group were lower than(18.43±5.31)U/ml and(2.28±0.27)μg/L in control group;the differences were all statistically significant(P<0.05).The total effective rate of the observation group was 90.48%,which was higher than 74.60%of the control group,and the difference was statistically significant(P<0.05).After treatment,the posterior cerebral artery blood flow velocity(73.37±8.77)cm/s,the middle cerebral artery blood flow velocity(80.17±13.39)cm/s,and anterior cerebral artery blood flow velocity(64.08±11.97)cm/s in the observation group were lower than(78.05±9.82),(88.28±13.03),and(72.39±12.72)cm/s in the control group,and the differences were all statistically significant(P<0.05).Conclusion Fasudil combined with butylphthalide can achieve satisfactory effect in elderly patients with vasospasm after intracranial aneurysm surgery,which has the value of further clinical promotion and application.