尼莫地平辅助治疗SAH后CVS的效果及对血清S100β蛋白、MCA血流速度的影响

Effect of Nimodipine in Adjuvant Treatment of SAH with CVS and its Effect on Serum S100βProtein and MCA Blood Flow Velocity

目的探讨尼莫地平对蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后脑血管痉挛(cerebral vasospasm,CVS)的辅助治疗作用。方法对SAH后CVS患者96例进行研究,均于2021年1月至2022年10月前来我院就诊,经奇偶数法分组,对照组和观察组各为48例。对照组仅应用依达拉奉治疗,观察组在对照组基础上辅助应用尼莫地平治疗,比较两组治疗效果、神经功能、意识状态、炎性因子水平和脑损伤程度。结果观察组总有效率为93.75%,高于对照组的75.00%(P<0.05);两组患者治疗前神经功能、意识状态、炎性因子和脑损伤程度无差异(P>0.05),治疗后观察组神经功能评分为(13.52±1.12)分,C反应蛋白为(34.21±3.78)mg/L,肿瘤坏死因子-α为(38.54±4.92)ng/L,白细胞介素-6为(8.32±2.21)ng/L,中枢神经特异性蛋白(S100β蛋白)为(0.17±0.04)μg/L,神经元特异性烯醇化酶(neuron-specific enolase,NSE)为(20.45±3.12)μ/L,大脑中动脉(middle cerebral artery,MCA)血流速度为(87.21±16.52)cm/s,均低于对照组,GCS评分高于对照组,数据差异显著(P<0.05)。结论在SAH后CVS患者的治疗中使用尼莫地平效果显著,对神经功能和意识状态均有改善作用,可减少炎性因子释放量,缓解脑损伤,存在广泛应用价值。

Objective To investigate the adjuvant effects of nimodipine on cerebral vasospasm(CVS)after subarachnoid hemorrhage(SAH).Methods A total of 96 patients with CVS after SAH were studied,all of whom came to our hospital from January 2021 to October 2022.They were divided by odd even number method,with 48 cases in control group and 48 cases in observation group.Edaravone alone was used in the control group,while nimodipine was used in combination with edaravone in the observation group.The therapeutic effect,neurological function,state of consciousness,levels of inflammatory cytokines and degree of brain injury were compared between the two groups.Results The total effective rate of observation group was 93.75%,which was higher than that of control group(75.00%).Neurological function,state of consciousness,inflammatory factors and degree of brain injury were no difference before treatment(P>0.05).Neurological function score,C-reactive protein(34.21±3.78)mg/L,tumor necrosis factor-α(38.54±4.92)ng/L in observation group after treatment were(13.52±1.12)points.Interleukin-6 was(8.32±2.21)ng/L,S100βprotein was(0.17±0.04)μg/L,neuron-specific enolase(NSE)was(20.45±3.12)μg/L,the blood flow velocity in the middle cerebral artery(MCA)was(87.21±16.52)cm/s,which was lower than that in the control group,and the GCS score was(14.21±0.72)points,which was higher than that in the control group(P<0.05).Conclusion The adjuvant use of nimodipine in the treatment of CVS patients after SAH has good results,which can improve the neurological function and consciousness state,can reduce the amount of inflammatory factors released,relieve brain injury,and is widely used.