尼莫地平联合前列地尔治疗动脉瘤性蛛网膜下腔出血脑血管痉挛患者的疗效分析

Curative Effect of Nimodipine Combined with Alprostadil in the Treat⁃ment of Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage

目的分析尼莫地平联合前列地尔治疗动脉瘤性蛛网膜下腔出血(Aneurysms Subarachnoid Hemor-rhage,aSAH)脑血管痉挛(Cerebral Vasospasm,CVS)的临床效果。方法方便选取2020年1月—2023年6月丰县中医医院收治的76例aSAH CVS患者为研究对象,以随机数表分为两组。对照组(38例)实施尼莫地平治疗,观察组(38例)实施尼莫地平联合前列地尔治疗。比较两组颅内血管平均血流速度、血清学指标、昏迷状态、认知功能评分及不良反应发生率。结果治疗后,观察组前、后、中动脉平均血流速度均较对照组低,差异有统计学意义(P均<0.05)。观察组白介素-6、血管内皮生长因子、超敏C反应蛋白及内皮素-1水平均较对照组更低,差异有统计学意义(P均<0.05)。观察组格拉斯哥昏迷评分、蒙特利尔认知量表评分分别为(12.41±2.23)、(26.02±1.97)分,高于对照组的(10.33±2.15)、(21.26±2.15)分,差异有统计学意义(t=4.139、10.062,P均<0.05)。观察组和对照组的不良反应总发生率分别为13.16%、10.53%,差异无统计学意义(P>0.05)。结论予以aSAH CVS患者尼莫地平联合前列地尔治疗,可改善颅内血管血流速度,改善患者昏迷状态与认知功能,保护血管内皮功能,减轻炎症反应,且不会增加不良反应。

Objective To analyze the clinical effect of nimodipine combined with alprostadil in the treatment of cere-bral vasospasm(CVS)in aneurysms subarachnoid hemorrhage(aSAH).Methods 76 patients with aSAH CVS admitted to Feng County Traditional Chinese Medicine Hospital from January 2020 to June 2023 were conveniently selected as the research subjects and randomly divided into two groups using a random number table.The control group(38 cases)received treatment with nimodipine,while the observation group(38 cases)received treatment with nimodipine com-bined with alprostadil.The mean intracranial blood flow velocity,serological indexes,coma state,cognitive function scores and the incidence of adverse reactions were compared between the two groups.Results After treatment,the av-erage blood flow velocity of the anterior,posterior,and middle arteries in the observation group was lower than that in the control group,and the differences were statistically significant(all P<0.05).The levels of interleukin-6,vascular endothelial growth factor,hypersensitive C-reactive protein,and endothelin-1 in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The scores of Glasgow Coma Scale and Montreal Cognitive Assessment of the observation group were(12.41±2.23)points and(26.02±1.97)points,respectively,higher than the control group's(10.33±2.15)points and(21.26±2.15)points,and the differences were statistically significant(t=4.139 and 10.062,both P<0.05).The total incidence of adverse reactions in the obser-vation group and the control group were 13.16%and 10.53%respectively,and the difference was not statistically sig-nificant(P>0.05).Conclusion In aSAH CVS patients,nimodipine combined with alprostadil can improve intracranial blood flow velocity,improve coma state and cognitive function,protect vascular endothelial function,reduce inflamma-tion,and do not increase adverse reactions.