法舒地尔联合尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床疗效

Clinical efficacy of fasudil in combind with nimodipine in the treatment of cerebral vasospasm after subarachnoid hemorrhage

目的探讨法舒地尔联合尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床疗效。方法选取2020年2月至2021年2月本院收治的86例蛛网膜下腔出血后脑血管痉挛患者作为研究对象,按照随机数字表法分为联合组与单一组,每组43例。单一组采用尼莫地平治疗,联合组采用法舒地尔联合尼莫地平治疗,比较两组临床疗效、大脑中动脉(MCA)血流速度、Fisher评分、血清核因子-κB(NF-κB)及基质金属蛋白酶-9(MMP-9)水平、不良反应发生情况。结果联合组治疗总有效率为95.35%,高于单一组的79.07%,差异有统计学意义(P<0.05)。治疗后,联合组MCA血流速度慢于单一组,Fisher评分低于单一组,差异有统计学意义(P<0.05)。治疗后,联合组血清NF-κB、MMP-9水平均低于单一组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论法舒地尔联合尼莫地平治疗蛛网膜下腔出血后脑血管痉挛效果确切,可改善患者MCA血流速度和脑缺血状况,用药安全性高,值得临床推广应用。

Objective To investigate the clinical efficacy of fasudil combined with nimodipine in the treatment of cerebral vasospasm after subarachnoid hemorrhage.Methods A total of 86 patients with cerebral vasospasm after subarachnoid hemorrhage admitted to our hospital from February 2020 to February 2021 were enrolled as study subjects,and they were divided into combination group and single group according to the random number table method,with 43 cases in each group,the clinical efficacy,middle cerebral artery(MCA)blood flow velocity,Fisher score,nuclear factor-κB(NF-κB)and matrix metalloproteinase-9(MMP-9)levels,and adverse reactions were compared between the two groups.Results The overall effective rate of treatment in the combination group was 95.35%,which was higher than 79.07%of the single group,and the difference was statistically significant(P<0.05).After treatment,MCA blood flow in the combination group was faster than that in the single group,and the Fisher score was lower than that in the single group,and the differences were statistically significant(P<0.05).After treatment,serum levels of NF-κB and MMP-9 in the combination group were lower than those in the single group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Fasudil combined with nimodipine has definite effect in the treatment of cerebral vasospasm after subarachnoid hemorrhage,which can improve the MCA blood flow rate and cerebral ischemia in patients,and the drug safety is high,which is worthy of clinical promotion and application.