尼莫地平辅助治疗高血压脑出血患者的临床疗效及对脑血流动力学的影响

Clinical effect of Nimodipine in the adjuvant treatment of hypertensive cerebral hemorrhage and its influence on cerebral hemodynamics

目的探讨尼莫地平辅助治疗高血压脑出血患者的临床疗效及对脑血流动力学的影响。方法选取2018年12月至2020年12月本院收治的100例高血压脑出血患者作为研究对象,随机分为对照组与研究组,每组50例。对照组采用苯磺酸氨氯地平片联合盐酸乌拉地尔注射液治疗,研究组在对照组基础上采用尼莫地平辅助治疗,比较两组脑血流动力学参数、脑水肿情况、神经功能缺损评分、氧化应激指标、炎症因子水平。结果治疗后,两组血流量、血流速度均快于治疗前,外周阻力均低于治疗前,且研究组血流量、血流速度均快于对照组,外周阻力低于对照组,差异有统计学意义(P<0.05)。治疗后,两组水中面积均小于治疗前,血肿量均少于治疗前,且研究组水中面积小于对照组,血肿量少于对照组,差异有统计学意义(P<0.05)。治疗后,两组美国国立卫生研究院卒中量表(NIHSS)评分均低于治疗前,研究组NIHSS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SOD水平均高于治疗前,丙二醛(MDA)水平均低于治疗前,且超氧化物歧化酶(SOD)水平高于对照组,MDA水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论尼莫地平辅助治疗高血压脑出血患者的临床疗效显著,有效稳定脑血流动力学,缓解脑水肿症状,减轻神经功能缺损程度及氧化应激反应,降低炎症水平,值得临床推广应用。

Objective To investigate the clinical efficacy of nimodipine in the adjuvant treatment of hypertensive cerebral hemorrhage and its influence on cerebral hemodynamics.Methods 100 patients with hypertensive cerebral hemorrhage admitted to our hospital from December 2018 to December 2020 were selected as the research subjects,and they were randomly divided into the control group and the study group,with 50 cases in each group.The control group was treated with amlodipine besylate tablets combined with urapidil hydrochloride injection,and the study group was treated with nimodipine on the basis of the control group,the cerebral hemodynamic parameters,brain edema,neurological deficit score,oxidative stress index and inflammatory factor levels were compared between the two groups.Results After treatment,the blood flow and blood flow velocity of the two groups were faster than those before treatment,and the peripheral resistance was lower than that before treatment,and the blood flow and blood flow velocity of the study group were faster than those of the control group,and the peripheral resistance was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,the water area and hematoma volume of the two groups were lower than those before treatment,and the water area and hematoma volume of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the National Institute of Health stroke scale(NIHSS)scores of the two groups were lower than those before treatment,and the NIHSS score of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the superoxide dismutase(SOD)level of the two groups was higher than that before treatment,and the malondialdehyde(MDA)level was lower than that before treatment,and the SOD level was higher than that of the control group,and the MDAlevel was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in two groups were lower than before,and the study group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion Nimodipine has significant clinical efficacy in the adjuvant treatment of patients with hypertensive cerebral hemorrhage,which can effectively stabilize cerebral hemodynamics,relieve cerebral edema symptoms,reduce the degree of neurological deficit and oxidative stress response,and reduce the level of inflammation,which isworthy of clinical application.