醒脑静联合纳洛酮对高血压脑出血患者神经功能、日常生活能力、脑水肿情况的影响

Effect of Xingnaojing combined with naloxone on neurological function,activities of daily living and cerebral edema in patients with hypertensive intracerebral hemorrhage

目的分析醒脑静与纳洛酮联合应用于高血压脑出血治疗中对患者神经功能、日常生活能力、脑水肿情况的影响。方法52例高血压脑出血患者,根据治疗方法不同分为对照组和观察组,每组26例。对照组采用纳洛酮单一治疗,观察组采用纳洛酮联合醒脑静治疗。比较两组患者日常生活能力量表(ADL)分级,治疗前后格拉斯哥昏迷指数量表(GCS)、美国国立卫生研究院卒中量表(NIHSS)评分及脑水肿指数、临床指标[血浆酸性磷脂(AP)、溶血磷脂酸(LPA)、神经元特异性烯醇化酶(NSE)、S100B蛋白以及基质金属蛋白酶-9(MMP-9)]。结果治疗后,观察组患者ADL分级优于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者GCS评分(11.14±2.43)分高于对照组的(8.52±0.19)分,NIHSS评分(7.01±0.22)分低于对照组的(9.96±4.90)分,差异具有统计学意义(P<0.05)。治疗后第10、15、25天,观察组患者脑水肿指数分别为(19.41±7.95)、(12.42±7.03)、(7.44±4.51),低于对照组的(25.86±6.78)、(17.98±4.57)、(11.19±7.07),差异具有统计学意义(P<0.05)。治疗后,观察组患者的血浆AP、LPA、NSE水平分别为(3.87±0.79)U/L、(1.71±0.25)μmol/L、(7.25±0.59)μg/L,均低于对照组的(4.66±0.67)U/L、(2.84±0.65)μmol/L、(11.71±4.53)μg/L,差异具有统计学意义(P<0.05)。治疗后,观察组患者S100B蛋白、MMP-9水平分别为(0.68±0.55)、(80.86±5.49)ng/ml,低于对照组的(0.95±0.82)、(90.33±9.31)ng/ml,差异具有统计学意义(P<0.05)。结论使用纳洛酮联合醒脑静对高血压脑出血患者进行治疗,不仅能够促进患者神经功能、日常生活能力得到有效提升,还能够进一步缓解和改善脑水肿情况,效果显著,值得推广。

Objective To analyze the effect of Xingnaojing combined with naloxone on neurological function,activities of daily living and cerebral edema in patients with hypertensive intracerebral hemorrhage.Methods A total of 52 patients with hypertensive intracerebral hemorrhage were divided into control group and observation group according to different treatment methods,with 26 cases in each group.The control group was treated with naloxone alone,and the observation group was treated with naloxone and Xingnaojing.Both groups were compared in terms of activities of daily living(ADL)grading,Glasgow Coma Scale(GCS),National Institutes of Health Stroke Scale(NIHSS)score,cerebral edema index,clinical indicators[plasma acidic phospholipids(AP),lysophosphatidic acid(LPA),neuron-specific enolase(NSE)and S100B protein,and matrix metalloproteinase-9(MMP-9)]before and after treatment.Results After treatment,the ADL grading of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).After treatment,GCS score of(11.14±2.43)points in the observation group was higher than that of(8.52±0.19)points in the control group,and NIHSS score of(7.01±0.22)points was lower than that of(9.96±4.90)points in the control group,and the difference was statistically significant(P<0.05).On the 10th,15th and 25th days after treatment,the cerebral edema index of the observation group were(19.41±7.95),(12.42±7.03)and(7.44±4.51),which were lower than those of(25.86±6.78),(17.98±4.57)and(11.19±7.07)of the control group,and the differences were statistically significant(P<0.05).After treatment,the plasma levels of AP,LPA and NSE were(3.87±0.79)U/L,(1.71±0.25)μmol/L and(7.25±0.59)μg/L in the observation group,which were lower than those of(4.66±0.67)U/L,(2.84±0.65)μmol/L and(11.71±4.53)μg/L in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of S100B protein and MMP-9 were(0.68±0.55)and(80.86±5.49)ng/ml in the observation group,which were lower than those of(0.95±0.82)and(90.33±9.31)ng/ml in the control group,and the differences were statistically significant(P<0.05).Conclusion Naloxone combined with Xingnaojing has significant effect on hypertensive intracerebral hemorrhage patients,which can not only improve the neurological function and activities of daily living,but also further alleviate and improve the situation of cerebral edema.It is worthy of promotion.