倍他司汀联合氟桂利嗪对椎-基底动脉供血不足性眩晕患者血流动力学指标及眩晕程度的影响

Effect of betahistine combined with flunarizine on hemodynamic indicators and degree of vertigo in patients with vertebrobasilar insufficiency

目的探讨倍他司汀联合氟桂利嗪治疗椎-基底动脉供血不足性眩晕(VBIV)的效果。方法队列研究。抽取2021年5月至2023年5月驻马店市第一人民医院收治的VBIV患者86例,按随机数字表法分为对照组与观察组,每组43例。对照组给予倍他司汀治疗,观察组加用氟桂利嗪治疗,均持续治疗4周。比较两组临床疗效、眩晕程度、血流动力学指标、血清学指标及不良反应发生率。结果观察组治疗总有效率(95.36%,41/43),高于对照组(91.40%,35/43),眩晕残障程度评定量表(DHI)评分[(14.34±2.33)分]低于对照组[(18.46±3.01)分],P<0.05。治疗后,观察组基底动脉血流速度、左侧椎动脉血流速度、右侧椎动脉血流速度[(58.42±6.41)、(43.42±4.58)、(46.57±5.79)cm/s]高于对照组[(50.56±5.35)、(36.20±4.64)、(36.92±5.16)cm/s],血清钙降素基因相关肽(CGRP)、超氧化物歧化酶(SOD)水平[(33.53±3.38)ng/L、(230.36±16.09)U/L]高于对照组[(28.52±3.61)ng/L、(212.20±15.13)U/L],一氧化氮(NO)、内皮素-1(ET-1)、丙二醛水平[(134.32±10.15)ng/L、(134.32±10.15)ng/L、(4.02±0.34)mmol/mL]低于对照组[(60.18±5.45)ng/L、(135.09±8.32)ng/L、(4.68±0.55)mmol/mL],差异均有统计学意义(P均<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论倍他司汀与氟桂利嗪联合能增强VBIV的治疗效果,减轻眩晕程度,改善血流动力学指标与血清学指标。

Objective To investigate the application effect of betahistine combined with flunarizine in patients with vertebrobasilar insufficiency vertigo(VBIV).Methods This study was a cohort study.Eighty-six VBIV patients admitted to Zhumadian First People’s Hospital from May 2021 to May 2023 were selected,and they were divided into a control group and an observation group by random number table method,with 43 cases in each group.The control group was treated with betahistine,while the observation group was treated with flunarizine for 4 weeks.The clinical efficacy,degree of dizziness,hemodynamic indicators,serological indicators,and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group(95.36%,41/43)was higher than that in the control group(91.40%,35/43),moreover,the score of the dizziness handicap inventory(DHI)in the observation group(14.34±2.33)was lower than that in the control group(18.46±3.01),P<0.05.After treatment,the basilar artery blood velocity,left vertebral artery blood velocity,and right vertebral artery blood flow velocity in the observation group were(58.42±6.41)cm/s,(43.42±4.58)cm/s,(46.57±5.79)cm/s,respectively,which were higher than(50.56±5.35)cm/s,(36.20±4.64)cm/s,and(36.92±5.16)cm/s in the control group(P<0.05).The levels of serum calciferin gene-related peptide and superoxide dismutase in the observation group were(33.53±3.38)ng/L and(230.36±16.09)U/L,respectively,which were higher than the(28.52±3.61)ng/L and(212.20±15.13)U/L in the control group(P<0.05).The levels of nitric oxide,endothelin-1 and malondialdehyde in the observation group were(134.32±10.15)ng/L,(134.32±10.15)ng/L,and(4.02±0.34)mmol/mL,respectively,which were lower than the(60.18±5.45)ng/L,(135.09±8.32)ng/L,adn(4.68±0.55)mmol/mL in the control group(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions Betahistine combined with flunarizine can enhance the therapeutic effect of VBIV,reduce the degree of dizziness,improve hemodynamic and serological indicators.