桂哌齐特联合法舒地尔治疗脑动脉瘤栓塞术后脑血管痉挛的效果

Effect of Cinepazide Combined with Fasudil in the Treatment of Cerebral Vasospasm after Cerebral Aneurysm Embolization

目的:探讨桂哌齐特联合法舒地尔治疗脑动脉瘤栓塞术后脑血管痉挛的效果。方法:选取2020年6月-2022年6月佳木斯市中心医院收治的124例脑动脉瘤栓塞术后脑血管痉挛患者,按照随机数字表法将患者分为对照组和观察组,各62例。对照组以法舒地尔治疗,观察组在对照组的基础上增加桂哌齐特。比较两组临床疗效、神经功能评分、脑血流动力学指标、脑损伤标志物水平、治疗安全性。结果:观察组总有效率为91.94%,高于对照组的77.42%(P<0.05)。治疗后,观察组神经功能缺损量表(NIHSS)评分低于对照组,简易智能精神状态检查量表(MMSE)评分高于对照组(P<0.05)。治疗后观察组大脑中动脉最大峰值流速(MPV)、平均流速(V_(m))、搏动指数(PI)均高于对照组,且血管阻力指数(RI)低于对照组(P<0.05)。治疗后,观察组人钙调素依赖性蛋白激酶2(CAMK2)、泛素羧基末端水解酶L1(UCH-L1)、神经纤维丝蛋白(NF)水平均低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:桂哌齐特联合法舒地尔治疗脑动脉瘤栓塞术后的脑血管痉挛有良好效果,可改善患者神经功能状态,增加脑部血流速度,抑制脑损伤标记蛋白表达水平。

Objective:To study the effect of Cinepazide combined with Fasudil in the treatment of cerebral vasospasm after cerebral aneurysm embolization.Method:A total of 124 patients with cerebral vasospasm after cerebral aneurysm embolization admitted to Jiamusi Central Hospital from June 2020 to June 2022 were selected,they were divided into control group and observation group according to random number table method,with 62 cases in each group.The control group was treated with Fasudil,and the observation group was added with Cinepazide on the basis of control group.The clinical efficacy,neurological function scores,cerebral hemodynamics indexes,brain injury markers and treatment safety were compared between the two groups.Result:The total effective rate of the observation group was 91.94%,which was higher than 77.42%of the control group(P<0.05).After treatment,the NIHSS score of the observation group was lower than that of the control group,and the mini mental state examination scale(MMSE)score of the observation group was higher than that of the control group(P<0.05).After treatment,the maximum peak velocity(MPV),Vmean(V_(m))and pulse index(PI)of middle cerebral artery of the observation group were higher than those of control group,and the vascular resistance index(RI)was lower than that of the control group(P<0.05).After treatment,the levels of calmodulin-dependent protein kinase 2(CAMK2),ubiquitin carboxyterminal hydrolase L1(UCH-L1)and neurofibroin(NF)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 the two groups(P>0.05).Conclusion:The combination of Cinepazide and Fasudil has a good effect on cerebral vasospasm after cerebral aneurysm embolization,it can improve the neurological function of patients,increase the cerebral blood flow velocity,inhibit the expression level of brain injury marker protein.